A 10-year update: national survey questionnaire of obstetric anesthesia units in Israel.

Anesthesia, Obstetrical / methods Humans Israel Prospective Studies Surveys and Questionnaires / statistics & numerical data
Cesarean Epidural Israel Labor National Survey

Journal

International journal of obstetric anesthesia
ISSN: 1532-3374
Titre abrégé: Int J Obstet Anesth
Pays: Netherlands
ID NLM: 9200430

Informations de publication

Date de publication:
05 2019
Historique:
received: 06 08 2018
revised: 07 10 2018
accepted: 26 10 2018
pubmed: 5 12 2018
medline: 21 1 2020
entrez: 5 12 2018
Statut: ppublish

Résumé

This nationwide survey was conducted to provide data about the obstetric anesthesia services in Israeli labor and delivery units in 2016. Prospective survey questionnaire was emailed to obstetric anesthesia unit directors/chairperson of all 25 labor and delivery services units within the jurisdiction of the Israeli Ministry of Health. The response rate was 100%. Nineteen (76%) units have dedicated anesthesiologist cover. Fifteen (60%) units offered nitrous oxide, four units (16%) offered patient-controlled intravenous fentanyl and six units (24%) offered patient-controlled intravenous remifentanil for alternative labor analgesia. The median (range) epidural rate was 60% (22-85%). The median (range) cesarean delivery rate was 20% (10-26%). Overall, general anesthesia was performed for median (range) 10% (1-25%) of cesarean deliveries. Neuraxial anesthesia was performed for 95% (40-99%) of elective and 60% (0-90%) of urgent cesarean deliveries. Intrathecal morphine was administered routinely for spinal anesthesia for post-cesarean delivery analgesia in 11 (44%) units. Nineteen (72%) units had a written aspiration prophylaxis protocol; 20 (80%) had a written labor analgesia protocol; 19 (76%) had a postdural puncture headache management protocol; 20 (80%) had a local anesthetic toxicity protocol; 24 units had Intralipid available in the unit. No new labor units have opened since 2005, despite huge increases in delivery volume in many units. These units manage increased numbers of epidurals and cesarean deliveries. Use of intrathecal morphine for spinal anesthesia has become more widespread. Future efforts should focus on availability of emergency equipment, separate obstetric anesthesia staffing, and establishing emergency protocols.

Sections du résumé

BACKGROUND
This nationwide survey was conducted to provide data about the obstetric anesthesia services in Israeli labor and delivery units in 2016.
METHODS
Prospective survey questionnaire was emailed to obstetric anesthesia unit directors/chairperson of all 25 labor and delivery services units within the jurisdiction of the Israeli Ministry of Health.
RESULTS
The response rate was 100%. Nineteen (76%) units have dedicated anesthesiologist cover. Fifteen (60%) units offered nitrous oxide, four units (16%) offered patient-controlled intravenous fentanyl and six units (24%) offered patient-controlled intravenous remifentanil for alternative labor analgesia. The median (range) epidural rate was 60% (22-85%). The median (range) cesarean delivery rate was 20% (10-26%). Overall, general anesthesia was performed for median (range) 10% (1-25%) of cesarean deliveries. Neuraxial anesthesia was performed for 95% (40-99%) of elective and 60% (0-90%) of urgent cesarean deliveries. Intrathecal morphine was administered routinely for spinal anesthesia for post-cesarean delivery analgesia in 11 (44%) units. Nineteen (72%) units had a written aspiration prophylaxis protocol; 20 (80%) had a written labor analgesia protocol; 19 (76%) had a postdural puncture headache management protocol; 20 (80%) had a local anesthetic toxicity protocol; 24 units had Intralipid available in the unit.
CONCLUSION
No new labor units have opened since 2005, despite huge increases in delivery volume in many units. These units manage increased numbers of epidurals and cesarean deliveries. Use of intrathecal morphine for spinal anesthesia has become more widespread. Future efforts should focus on availability of emergency equipment, separate obstetric anesthesia staffing, and establishing emergency protocols.

Identifiants

DOI: 10.1016/j.ijoa.2018.10.014 PMID: 30509678
pubmed: 30509678
pii: S0959-289X(18)30357-1
doi: 10.1016/j.ijoa.2018.10.014
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

83-92

Informations de copyright

Copyright © 2018. Published by Elsevier Ltd.

Auteurs

D Shatalin (D)

Department of Anesthesiology, Perioperative Medicine & Pain Treatment, Shaare Zedek Medical Center, Affiliated with the Hadassah-Hebrew University Medical School Ein-Kerem, Jerusalem, Israel.

C F Weiniger (CF)

Department of Anesthesiology, Hadassah Hebrew University Medical Center, Jerusalem, Israel; Division of Anesthesia, Critical Care and Pain, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel. Electronic address: carolynfweiniger@gmail.com.

I Buchman (I)

Department of Anesthesiology, Perioperative Medicine & Pain Treatment, Shaare Zedek Medical Center, Affiliated with the Hadassah-Hebrew University Medical School Ein-Kerem, Jerusalem, Israel.

Y Ginosar (Y)

Department of Anesthesiology, Hadassah Hebrew University Medical Center, Jerusalem, Israel.

S Orbach-Zinger (S)

Department of Anesthesia, Rabin Medical Center (Beilinson Campus), Petah Tikvah, Tel Aviv University, Tel Aviv, Israel.

A Ioscovich (A)

Department of Anesthesiology, Perioperative Medicine & Pain Treatment, Shaare Zedek Medical Center, Affiliated with the Hadassah-Hebrew University Medical School Ein-Kerem, Jerusalem, Israel.

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Classifications MeSH

questionsmedicales.fr › Anesthésie et analgésie › Anesthésie › Anesthésie obstétricale › A 10-year update: national survey...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › A 10-year update: national survey...
questionsmedicales.fr › Régions géographiques › Asie › Asie de l'Ouest › Moyen Orient › Israël › A 10-year update: national survey...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études prospectives › A 10-year update: national survey...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Collecte de données › Enquêtes et questionnaires › A 10-year update: national survey...