title: [A survey of anaesthesia for caesarean section in Poland].
abstract: BACKGROUND
  Obstetric anaesthesia and analgesia have come to be regarded as a subspecialty.Various countries and societies have published evidence-based guidelines. In this paper are presented the results of a survey of anaesthesia for Caesarean section (CS), conducted in Poland in 2009.
  
  
  METHODS
  432 questionnaires were sent. The questions asked related to: characteristics of the hospital, premedication, preoperative laboratory screening, methods of anaesthesia, local analgesic agents (LA), postoperative enteral feeding, positioning, and analgesia.
  
  
  RESULTS
  The questionnaire return rate was 24%. Only 10 hospitals (out of 98) employed anaesthesiologists exclusively for obstetric anaesthesia and analgesia. Alkalinisation of gastric contents, gastric emptying drugs and H blockers were used in 38% of hospitals in elective CS, and in 32% of hospitals in emergency CS. Preoperative laboratory screening was conducted in 93% of hospitals before elective CS, and 77% before emergency CS (usually haematocrit, haemoglobin concentration, red blood count and platelets). In 50% of hospitals, the lowest acceptable concentration of platelets before central blocks was 100,000; while in 30% of hospitals, a level of 50,000 was considered acceptable. Spinal anaesthesia was used in more than 90% of elective CS cases in 75% of hospitals, in emergency CS--in 50% of patients only and in the presence of a foetal stress in 65% of hospitals general anaesthesia was preferred. Bupivacaine remains the most commonly used LA (97%). Lidocaine is still used in 3% of hospitals, and adjuvants are used in 42% of hospitals. The flat supine position was recommended in 75% of hospitals; and 13% of parturients were requested to stay in this position for 24 hours. In 74% of hospitals, enteral feeding was delayed, and in 27% was delayed for 24 hours after CS (27%). Postoperative analgesia was based on parenteral analgesics (usually paracetamol and ketoprofen). Pethidine was used in 35% of hospitals.
  
  
  CONCLUSIONS
  There is an urgent need for national guidelines on obstetric anaesthesia and analgesia in Poland.
authors.affiliation: Oddział Anestezjologii i Intensywnej Terapii, Tczewskie Centrum Zdrowia.
authors.forename: Jacek
authors.initials: J
authors.lastname: Furmanik
mesh_terms: D000328:Adult; D016362:Analgesia, Obstetrical / Q000706:statistics & numerical data; D000768:Anesthesia, General / Q000706:statistics & numerical data; D000773:Anesthesia, Obstetrical / Q000706:statistics & numerical data*; D000775:Anesthesia, Spinal / Q000706:statistics & numerical data; D002585:Cesarean Section / Q000706:statistics & numerical data*; D004363:Drug Utilization / Q000706:statistics & numerical data; D004750:Enteral Nutrition / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008614:Meperidine / Q000008:administration & dosage; D011044:Poland; D011159:Population Surveillance; D011247:Pregnancy; D016683:Supine Position; D011795:Surveys and Questionnaires
chemical_list: D008614:Meperidine