Anaesthesia for minor surgery in the early postpartum period - Czech and Slovak prospective national surveys
Abstract
Objectives: To determine the anaesthesia practice for early postpartum procedures in the Czech Republic (CZE) and Slovakia (SK). Design: International, prospective, observational.
Departments: 105 departments providing obstetric anaesthesia in CZE and SK. Methods: With Ethical Committee approval we aimed to enrol all the 149 obstetric departments in CZE and SK and to monitor every case of anaesthetic care in the peripartum period during November 2015.
The data were recorded into CLADE-IS database through a Case Report Form consisting of two parts (Demography 2014 and Case Report). The database was analysed descriptively with SPSS24 software.
Results: We enrolled 105 centres (70.5%) representing 87.7% of all births in the CZE (7256 out of 8275) and 66.4% in the SK (2863 out of 4311). There were 3523 cases of anaesthetic care in the peripartum period, of which 181(5.1%) were in the early postpartum period: manual lysis (108, 59.7%), postpartum uterine cavity revision (61, 33.7%) and sewing of extensive birth injuries (58, 32.0%).
The mode of anaesthesia was general (168, 92.8%), or epidural (13, 7.2%) in parturients with an epidural catheter in-situ. The airway was secured with face mask (117, 64.6%) or orotracheal intubation (32, 17.7%).
Rapid Sequence Induction and succinylcholine (27, 84.4%) with cricoid pressure (8, 29.6%) were used for intubation. The anaesthetic agent used for induction was propofol (147, 81.2%). ketamine (29, 16.0%) or thiopental (8.44%).
Analgesia was provided with sufentanil (78, 43.0%) and alfentanil (51, 28.2%). Conclusion: Anaesthetists in the Czech Republic and Slovakia prefer general anaesthesia with face mask and propofol for minor surgery in the postpartum period.