title: Anesthesia for cesarean delivery in the Czech Republic: a 2011 national survey.
abstract: BACKGROUND
  The purpose of this national survey was to determine current anesthesia practices for cesarean delivery in the Czech Republic.
  
  
  METHODS
  In November 2011, we invited all departments of obstetric anesthesia in the Czech Republic to participate in a prospective study to monitor consecutive peripartum obstetric anesthesia procedures. Data were recorded online in the TrialDB database (Yale University, New Haven, CT).
  
  
  RESULTS
  The response rate was 51% (49 of 97 departments); participating centers represented 60% of all births in the country during the study period. There were 1943 cases of peripartum anesthesia care, of which 1166 cases (60%) were anesthesia for cesarean delivery. Estimates were weighted based on population distribution of cesarean delivery among types of participating centers. Neuraxial anesthesia was used in 55.6% (95% confidence interval [CI], 52.8%-58.5%); the distribution of anesthesia techniques differed among type of participating center. The rate of neuraxial anesthesia in university hospitals was 55.6% (95% CI, 51.5%-59.6%), 32.4% (95% CI, 26.4%-39.0%) in regional hospitals, and 60.7% (95% CI, 55.2%-66.0%) in local hospitals. The reasons for cesarean delivery under general anesthesia were emergency procedure (67%), refusal of neuraxial blockade by parturient (30%), failure of neuraxial anesthesia (6%), and preoperative administration of low-molecular-weight heparin (3%). Postcesarean analgesia was primarily provided by systemic opioid (66%) and nonopioid analgesics (61%), solely or in combination. Epidural postoperative analgesia was used in 14% of cases. Compared with national neuraxial anesthesia rate data published in the 1990s (6.7% in 1993), there has been an upward trend in the use of neuraxial anesthesia for cesarean delivery during the 21st century (40.5% in 2000) in the Czech Republic.
  
  
  CONCLUSIONS
  The rate of neuraxial anesthesia use for cesarean delivery has increased in the Czech Republic in the last 2 decades. However, the current rate of general anesthesia is high compared with other Western countries.
authors.affiliation: From the *Medical Faculty of Masaryk University and University Hospital Brno, Brno, Czech Republic; Expert Committee of Labor Anesthesia and Analgesia of the Czech Society of Anesthesiology and Intensive Care Medicine, Prague, Czech Republic; †1st Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic; Expert Committee of Labor Anesthesia and Analgesia of the Czech Society of Anesthesiology and Intensive Care Medicine, Prague, Czech Republic; ‡2nd Faculty of Medicine, Charles University and Motol University Hospital in Prague, Prague, Czech Republic; Expert Committee of Labor Anesthesia and Analgesia of the Czech Society of Anesthesiology and Intensive Care Medicine, Prague, Czech Republic; §University Hospital Brno, Brno, Czech Republic; Expert Committee of Labor Anesthesia and Analgesia of the Czech Society of Anesthesiology and Intensive Care Medicine, Prague, Czech Republic; and ‖Institute of Biostatistics and Analyses, Masaryk University, Brno, Czech Republic.
authors.forename: Petr
authors.initials: P
authors.lastname: Stourac
authors.forename: Jan
authors.initials: J
authors.lastname: Blaha
authors.forename: Radka
authors.initials: R
authors.lastname: Klozova
authors.forename: Pavlina
authors.initials: P
authors.lastname: Noskova
authors.forename: Dagmar
authors.initials: D
authors.lastname: Seidlova
authors.forename: Lucie
authors.initials: L
authors.lastname: Brozova
authors.forename: Jiri
authors.initials: J
authors.lastname: Jarkovsky
mesh_terms: D015360:Analgesia, Epidural / Q000639:trends; D016362:Analgesia, Obstetrical / Q000639:trends; D000765:Anesthesia, Conduction / Q000009:adverse effects / Q000639:trends*; D000768:Anesthesia, General / Q000639:trends; D000773:Anesthesia, Obstetrical / Q000009:adverse effects / Q000639:trends*; D000775:Anesthesia, Spinal / Q000639:trends; D002585:Cesarean Section / Q000009:adverse effects / Q000639:trends*; D018153:Czech Republic; D017558:Elective Surgical Procedures; D004630:Emergencies; D005260:Female; D019538:Health Care Surveys; D061847:Hospitals, High-Volume / Q000639:trends; D061846:Hospitals, Low-Volume / Q000639:trends; D006785:Hospitals, University / Q000639:trends; D006801:Humans; D010149:Postoperative Pain / Q000517:prevention & control; D010818:Practice Patterns, Physicians' / Q000639:trends*; D011247:Pregnancy; D013997:Time Factors; D016896:Treatment Outcome