title: Current practice in postoperative epidural analgesia: a german survey.
abstract: We surveyed current German practice in postoperative epidural analgesia (EA). Of 300 questionnaires sent anonymously, 147 (49%) were returned fully completed. A 24-h acute pain service (APS) was offered in 41% of German hospitals. Seventy percent of the large teaching hospitals (>1000 beds) offered an APS, whereas just 9% of the hospitals of <500 beds provided an APS. Small-size hospitals (<200 beds) preferred ropivacaine as the local anesthetic (LA) in contrast to large teaching hospitals using more bupivacaine than ropivacaine. In the general ward setting, 36% of the respondents used plain LA, and 64% combined the LA with an opioid. If ropivacaine was used, 0.2% was the most popular concentration (78%), combined with morphine (17%), fentanyl (14%), or sufentanil (75%). If bupivacaine was used, 0.25% was the preferred concentration (30%), combined with morphine (40%), fentanyl (8%), or sufentanil (60%). On wards, 58% of German anesthetic departments used continuous epidural infusion, 57% bolus doses, and 20% patient-controlled EA mode. We conclude that the availability of a 24-h APS (41%) in German hospitals corresponds favorably to international data. EA with the combination of LAs and opioids was the most common modality in the ward setting.
  
  
  CONCLUSIONS
  We surveyed current German practice in postoperative epidural analgesia. We found that the availability of a 24-h acute pain service (41%) in German hospitals corresponds favorably to international practice. Epidural analgesia with the combination of local anesthetics and opioids was the most common modality in the ward setting.
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, University of Cologne, Germany. sandra.kampe@medizin.uni-koeln.de
authors.forename: Sandra
authors.initials: S
authors.lastname: Kampe
authors.forename: Peter
authors.initials: P
authors.lastname: Kiencke
authors.forename: Jens
authors.initials: J
authors.lastname: Krombach
authors.forename: Karen
authors.initials: K
authors.lastname: Cranfield
authors.forename: Stefan Mario
authors.initials: SM
authors.lastname: Kasper
authors.forename: Christoph
authors.initials: C
authors.lastname: Diefenbach
mesh_terms: D015360:Analgesia, Epidural; D005858:Germany; D006801:Humans; D010149:Postoperative Pain / Q000188:drug therapy*