Practice patterns of anesthesiologists regarding situations in obstetric anesthesia where clinical management is controversial.
A survey consisting of 47 questions, 40 regarding clinical practice and 7 regarding demographics, was mailed to 153 directors of obstetric anesthesia in academic practice and to 153 anesthesiologists in private practice. Questions relating to the following areas of practice were asked: 1) preoperative laboratory testing; 2) preeclampsia and possible coagulopathies; 3) epidural catheter placement in women with "spinal problems"; and 4) use of epidural opioids and intravenous supplementation. Surveys were returned by 113 (74%) academic anesthesiologists and 94 (61%) private practice anesthesiologists. By univariate analysis, 14 questions showed a significant difference in response between those in academic and private practice, but only eight remained significant after accounting for the amount of clinical time currently devoted to obstetric anesthesia (>50% or < or = 50%). These eight questions related to preoperative laboratory testing in the healthy parturient, preoperative laboratory testing in the preeclamptic patient, and the use of intravenous supplementation during a cesarean section with regional anesthesia. Although there were some differences in the responses between anesthesiologists in academic and private practice, overall the responses were similar.
Beilin
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Department of Anesthesiology, Mount Sinai School of Medicine, New York, New York, USA.
Bodian
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CA
Haddad
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Leibowitz
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AB
D000046:Academic Medical Centers; D000328:Adult; D015360:Analgesia, Epidural; D016362:Analgesia, Obstetrical; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use; D000704:Analysis of Variance; D000765:Anesthesia, Conduction; D000767:Anesthesia, Epidural; D000773:Anesthesia, Obstetrical; D000776:Anesthesiology; D001778:Blood Coagulation Disorders / Q000503:physiopathology; D002585:Cesarean Section; D019411:Clinical Laboratory Techniques; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D010818:Practice Patterns, Physicians'; D011225:Pre-Eclampsia / Q000503:physiopathology; D011247:Pregnancy; D011300:Preoperative Care; D011331:Private Practice; D013122:Spinal Diseases / Q000503:physiopathology
D000701:Analgesics, Opioid