Anesthesia for Cesarean Delivery in the Czech Republic

Štourač, Petr; Bláha, J; Klozová, Radka; Nosková, Pavlína; Seidlová, Dagmar; Brožová, Lucie; Jarkovský, Jiří

doi:10.1213/ane.0000000000000572

Cited by 27 publications

(27 citation statements)

References 11 publications

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“…One report from Georgia cited lack of governmental funding for supplies, lack of familiarity of anesthesia staff with current techniques and evidence-based guidelines, and limited availability of appropriate local anesthetics as possible reasons (10). Another survey of RA use from the Czech Republic cited patient fear over the safety of RA and lack of acceptance by obstetric providers (9), similar to a report of an ongoing collaboration in China between Chinese and American anesthesia providers (11). …”

Section: Introductionmentioning

confidence: 68%

“…RA is associated with a lower maternal mortality risk compared to general anesthesia (GA) in both high and low- and middle-income countries (LMICs) (3–7). Despite this recognition, many Eastern European countries report much lower rates of RA use for CD and neuraxial analgesia for labor (NAL) (8, 9). Barriers to implementation in such settings are varied.…”

Section: Introductionmentioning

confidence: 99%

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Increasing Regional Anesthesia Use in a Serbian Teaching Hospital through an International Collaboration

Baysinger

Pujic

Veličković

et al. 2017

Front. Public Health

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Many low- and middle-income countries (LMICs) report low rates of regional anesthesia (RA) use for cesarean delivery (CD), despite its association with lower maternal major morbidity and mortality. Also, the prevalence of neuraxial analgesia for labor (NAL) is often low in LMICs. We report on the results of a collaboration in clinical education over a multi-year period between Kybele Inc., an international non-profit organization, and Klinicki Centar Vojvodine (CCV), a teaching hospital in Novi Sad, Serbia, to increase RA use for CD and NAL at CCV. From late 2011 through 2015, teams from Kybele participated in annual to biannual didactic conferences and week-long bedside teaching efforts involving obstetric and anesthesia staff from CCV and surrounding hospitals. Ongoing contact occurred at least weekly between Kybele and the host to discuss progress. De-identified quality improvement data on total deliveries, numbers of elective and non-elective CDs, number of vaginal deliveries, type of anesthesia for CD, and the number of NALs were collected. RA use for CD increased to 25% in year 2015 versus 14% in base year 2011 [odds ratio (OR): 2.05; 95% confidence interval (CI): 1.73,2.42; p < 0.001]. NAL increased to 10.5% of laboring women in 2015 versus 1.2% in 2011 (OR: 9.6; 95% CI: 7.2, 12.8; p < 0.001). Greater increases for RA use during non-elective CD were observed between 2011 and 2015 (1.4 versus 7.5% of total CD; OR: 5.52; 95% CI: 2.63, 8.41; p < 0.001) relative to elective CD (12.5 versus 17.5% of total CD; OR: 1.48; 95% CI: 1.23, 1.77; p < 0.001). Overall, RA for CD increased during the 4 year collaboration but was not as great as reported in other countries with similar health-care demographics utilizing a similar program. Detailed descriptions of program interventions and barriers to change at CCV are presented.

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Section: Introductionmentioning

confidence: 68%

Section: Introductionmentioning

confidence: 99%

Increasing Regional Anesthesia Use in a Serbian Teaching Hospital through an International Collaboration

Baysinger

Pujic

Veličković

et al. 2017

Front. Public Health

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“…The rate of GA for CS in the hospital was described as 29.5% in 2014 (Stourac et al., 2015). In our study group, we reported 35% C‐sections, 2.85% assisted vaginal deliveries, and 15.7% parturients received EOA.…”

Section: Discussionmentioning

confidence: 99%

“…We reported six cases of obstetric indications in 25 cases of CS and another 18 cases as neurological indications due to MS. One literature review and meta‐analysis showed possible higher prevalence of C‐sections (between 9.6% and 41.10%) as a reflection of cultural, religious, geographical and regional backgrounds (Finkelsztejn et al., 2011). Another remarkable finding is the rate of GA for CS in the MS group (64%) that is more than twice as high asthe routine CS rate in the University Hospital Brno (29.5%) (Stourac et al., 2015). The GA rate for an obstetric patient in this investigation exceeds by far that reported by Drake et al.…”

Section: Discussionmentioning

confidence: 99%

Obstetric anesthesia/analgesia does not affect disease course in multiple sclerosis: 10‐year retrospective cohort study

et al. 2018

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ObjectivesMultiple sclerosis (MS) often occurs in young women and the effect of obstetric anesthesia/analgesia on the disease is poorly understood. No previous study has investigated the course of the disease in women in labor in the Czech Republic. The aim of this study was to evaluate the occurrence or absence of relapses in the 6‐month postpartum period in MS parturients with and without obstetric anesthesia/analgesia.Materials and MethodsWe retrospectively studied all deliveries (n = 58,455) at the University Hospital Brno from 2004 to 2013 and identified those of the women with an ICD‐10 code G35 (MS) recorded anytime in their medical history (n = 428). We included only deliveries of women with confirmed diagnosis at the time of labor (n = 70). Statistical analysis was performed using the Fischer Exact Test.ResultsThere were 70 deliveries of 65 women, including 45 vaginal deliveries and 25 Cesarean deliveries (16 under general anesthesia, 8 with epidural anesthesia and 1 with spinal anesthesia). Epidural obstetric analgesia was performed in 11 deliveries. There was no statistically significant difference in relapses between the vaginal delivery group (n = 15; 33%) and Cesarean section group (n = 10; 40%), p = 0.611.ConclusionNeither delivery mode (vaginal vs Caesarean) nor type of obstetric anesthesia/analgesia was found to have any impact on the course of MS at 6 months postpartum in women with this condition.

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“…5 Beberapa obat anestesi lokal, yaitu ropivakain dan levobupivakain dapat menjadi obat pilihan pada blokade neuroaksial karena memiliki toksisitas yang rendah meskipun diberikan dalam jumlah yang banyak. 6 Bupivakain merupakan obat anestesi lokal yang sangat kardiotoksik, namun masih menjadi obat anestesi lokal yang paling banyak digunakan oleh dokter anestesi 7 termasuk di Jawa Barat. Hal ini dikarenakan harganya yang lebih murah dan mudah didapat dibanding dengan ropivakain maupun levobupivakain.…”

Section: Pembahasanunclassified

Penggunaan Anestesi Lokal dan Adjuvan pada Analgesi Epidural di Wilayah Jawa Barat Tahun 2015

Yadi¹,

Ibnu²,

Oktaliansah³

2017

jap

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AbstrakAnalgesi epidural yang optimal akan menghasilkan penanganan nyeri yang baik dengan efek samping minimal dan meningkatkan kepuasan pasien. Sampai saat ini belum terdapat data di Indonesia khususnya di wilayah Jawa Barat mengenai penggunaan anestesi lokal dan adjuvan pada analgesi epidural. Tujuan penelitian ini mecari data mengenai penggunaan anestesi lokal dan adjuvan yang digunakan oleh dokter spesialis anestesi di wilayah Jawa Barat pada tahun 2015. Penelitian ini dilakukan pada bulan Agustus hingga September 2016 di Departemen Anestesiologi dan Terapi Intensif RSUP Dr. Hasan Sadikin Bandung. Penelitian ini bersifat deskriptif dengan pengambilan data menggunakan kuesioner dan pendekatan cross sectional. Kuesioner dikirimkan kepada 120 dokter spesialis anestesi di Jawa Barat melalui jasa pos dan 30 kuesioner diberikan langsung kepada dokter spesialis anestesi yang bekerja di RSUP Dr. Hasan Sadikin Bandung. Angka respons yang didapatkan sebesar 47,3%. Hasil penelitian ini didapatkan dokter spesialis anestesi di Jawa Barat yang masih melakukan analgesi epidural pada tahun 2015 sebesar 73,2%. Obat anestesi lokal yang paling banyak digunakan untuk analgesi epidural adalah bupivakain sebesar 94,23%. Konsentrasi terbanyak 0,125% sebesar 82%. Adjuvan yang paling banyak digunakan adalah fentanil sebesar 96,9%. Simpulan penelitian ini sebagian besar dokter spesialis anestesi masih menggunakan epidural sebagai analgesi sehingga bupivakasin dan fentanil menjadi obat terbanyak yang digunakan. Kata kunci: Analgesi epidural, anestesi lokal, adjuvan Local Anesthetics and Adjuvants Use for Epidural Analgesia in West Java in 2015 AbstractUncontrolled postoperative pain may cause significant complication on many organs. Adequate postoperative, labor, and chronic pain relief has always been the goal of an anesthesiologist. This goal, however, is not always achieved and continues become a challenge for anesthesiologist. Optimum epidural analgesia should promote effective pain relief with minor adverse event and it can increase patient's satisfaction.

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Anesthesia for Cesarean Delivery in the Czech Republic

Abstract: The rate of neuraxial anesthesia use for cesarean delivery has increased in the Czech Republic in the last 2 decades. However, the current rate of general anesthesia is high compared with other Western countries.

Cited by 27 publications

References 11 publications

Increasing Regional Anesthesia Use in a Serbian Teaching Hospital through an International Collaboration

Increasing Regional Anesthesia Use in a Serbian Teaching Hospital through an International Collaboration

Obstetric anesthesia/analgesia does not affect disease course in multiple sclerosis: 10‐year retrospective cohort study

Penggunaan Anestesi Lokal dan Adjuvan pada Analgesi Epidural di Wilayah Jawa Barat Tahun 2015

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