Use of local anaesthetics and adjuncts for spinal and epidural anaesthesia and analgesia at German and Austrian University Hospitals: an online survey to assess current standard practice.
BACKGROUND
The present anonymous multicenter online survey was conducted to evaluate the application of regional anaesthesia techniques as well as the used local anaesthetics and adjuncts at German and Austrian university hospitals.


METHODS
39 university hospitals were requested to fill in an online questionnaire, to determine the kind of regional anaesthesia and preferred drugs in urology, obstetrics and gynaecology.


RESULTS
33 hospitals responded. No regional anaesthesia is conducted in 47% of the minor gynaecological and 44% of the urological operations; plain bupivacaine 0.5% is used in 38% and 47% respectively. In transurethral resections of the prostate and bladder no regional anaesthesia is used in 3% of the responding hospitals, whereas plain bupivacaine 0.5% is used in more than 90%. Regional anaesthesia is only used in selected major gynaecological and urological operations. On the contrary to the smaller operations, the survey revealed a large variety of used drugs and mixtures. Almost 80% prefer plain bupivacaine or ropivacaine 0.5% in spinal anaesthesia in caesarean section. Similarly to the use of drugs in major urological and gynaecological operations a wide range of drugs and adjuncts is used in epidural anaesthesia in caesarean section and spontaneous delivery.


CONCLUSIONS
Our results indicate a certain agreement in short operations in spinal anaesthesia. By contrast, a large variety concerning the anaesthesiological approach in larger operations as well as in epidural analgesia in obstetrics could be revealed, the causes of which are assumed to be primarily rooted in particular departmental structures.
Wahlen
Bianca M
BM
Staff Anaesthesiologist, University of Wuerzburg, Department of Anaesthesia and Critical Care, Wuerzburg, Germany. wahlen_b@klinik.uni-wuerzburg.de.
Roewer
Norbert
N
Kranke
Peter
P
Br J Anaesth. 2006 Jan;96(1):111-7
16257994
Anesth Analg. 2005 Nov;101(5):1512-1515
16244022
Anesth Analg. 1998 Mar;86(3):598-612
9495424
Health Bull (Edinb). 1996 Jan;54(1):51-62
8820230
Int J Chron Obstruct Pulmon Dis. 2007;2(4):493-515
18268924
Anesth Analg. 2001 Oct;93(4):853-8
11574345
Best Pract Res Clin Anaesthesiol. 2002 Dec;16(4):527-47
12516890
Acta Anaesthesiol Scand. 2004 Nov;48(10):1240-4
15504182
Anaesthesist. 2006 Jan;55(1):80-92
16175343
Int J Obstet Anesth. 2007 Jan;16(1):22-8
17125998
Anaesthesia. 1999 Jul;54(7):634-40
10417453
Anaesthesist. 1997 Feb;46(2):121-5
9133173
Reg Anesth Pain Med. 2007 Jul-Aug;32(4):330-8
17720118
Anaesthesia. 2001 Jun;56(6):526-9
11412157
Eur J Anaesthesiol. 2006 Feb;23(2):142-8
16426469
Anaesthesia. 2008 May;63(5):516-9
18412650
Reg Anesth. 1991 Mar-Apr;16(2):101-6
2043522
Reg Anesth Pain Med. 2008 Mar-Apr;33(2):159-67
18299097
Acta Anaesthesiol Scand. 2005 Feb;49(2):170-6
15715617
J Anesth. 2006;20(4):290-9
17072694
Pain. 1994 Apr;57(1):117-123
8065788
Anesthesiology. 2009 Jan;110(1):58-66
19104171
Anesth Analg. 2004 Oct;99(4):1231-1238
15385382