Anaesthetic practices for scheduled caesarean delivery: a 2005 French national survey.
OBJECTIVE
It is not known whether anaesthetic practices for ASA I parturients undergoing scheduled caesarean delivery have changed since the last (1996) survey and how practices reflect current recommendations.


METHODS
A 26-item survey questionnaire (organization of the maternity unit, preoperative evaluation, technical aspects describing regional or general anaesthesia, oxytocic and antibiotic drugs, postoperative analgesia) was distributed to all French obstetric units (excluding overseas).


RESULTS
The response rate was 73% (451/621). Preoperative evaluation included a recent platelet count in 97% of responding units, and information was given to patients in 84% of cases. Antibiotic prophylaxis in accordance with French guidelines was used in 78% of units. Anaesthetic techniques were single-shot spinal, epidural, combined spinal epidural and general anaesthesia in decreasing order (92.5, 4.5, 2 and 1%, respectively). Effervescent cimetidine was the first choice in 62% of units. Cricoid pressure and succinylcholine were routinely used in 66 and 77% of units, respectively. Oxytocin was used appropriately in 65% of units. In addition to spinal or epidural opioids, paracetamol, NSAIDs and nefopam were added postoperatively in 98, 68 and 19% of units, respectively. Poorer practices were found in units having a lower annual delivery rate.


CONCLUSIONS
Overall practice was in accordance with national guidelines or practice patterns defined by the expert committee. Regional anaesthesia and postoperative analgesia-related techniques particularly were adequate. Some deficits were of limited importance (antibiotic prophylaxis and oxytocin administration), whereas others (use of succinylcholine and cricoid pressure) remain of concern.
AP-HP, Service d'Anesthésie-Réanimation, Hôpital Bicêtre, Le Kremlin-Bicêtre, France. dan.benhamou@bct.aphp.fr
Dan
D
Benhamou
Hervé
H
Bouaziz
Dominique
D
Chassard
Jean-Claude
JC
Ducloy
Valérie
V
Fuzier
Marc
M
Laffon
Frédéric
F
Mercier
Marc
M
Raucoules
Kamran
K
Samii
D000328:Adult; D000769:Anesthesia, Inhalation; D000773:Anesthesia, Obstetrical; D019072:Antibiotic Prophylaxis / Q000706:statistics & numerical data; D002585:Cesarean Section; D003413:Cricoid Cartilage / Q000502:physiology; D004363:Drug Utilization; D005260:Female; D005602:France; D017408:Guidelines as Topic; D019538:Health Care Surveys; D006801:Humans; D009467:Neuromuscular Depolarizing Agents; D009775:Obstetrics and Gynecology Department, Hospital / Q000706:statistics & numerical data; D010121:Oxytocin / Q000627:therapeutic use; D010149:Postoperative Pain / Q000188:drug therapy; D011247:Pregnancy; D011300:Preoperative Care / Q000706:statistics & numerical data; D053120:Respiratory Aspiration / Q000517:prevention & control; D013390:Succinylcholine; D011795:Surveys and Questionnaires
D009467:Neuromuscular Depolarizing Agents; D010121:Oxytocin; D013390:Succinylcholine