Current Practice in Obstetric Anaesthesia.
Part III. Regional anaesthesia for caesarean section

Česká verzia

Authors: Bláha Jan ^1,2; Nosková Pavlína ^1,2; Klozová Radka ^1,3; Seidlová Dagmar ^1,4; Štourač Petr ^1,5; Pařízek Antonín ⁶
Authors place of work: Expertní skupina pro porodnickou anestezii a analgezii ČSARIM ¹; Klinika anesteziologie, resuscitace a intenzivní medicíny, 1. LF UK v Prazea Všeobecná fakultní nemocnice v Praze ²; Klinika anesteziologie a resuscitace, 2. LF UK v Praze a Fakultní nemocnice v Motole ³; II. anesteziologicko-resuscitační oddělení Fakultní nemocnice Brno ⁴; Klinika anesteziologie, resuscitace a intenzivní medicíny, LF MU a Fakultní nemocnice Brno ⁵; Gynekologicko-porodnická klinika, 1. LF UK v Praze a Všeobecná fakultní nemocnice v Praze ⁶
Published in the journal: Anest. intenziv. Med., 25, 2014, č. 1, s. 29-39
Category: Postgraduate Education - Expert group of obstetric anaesthesia and analgesia

Summary

Nearly a quarter of all births in the Czech Republic end by caesarean section in the recent years. With the increasing age of mothers, number of comorbidities, deliveries after previous caesarean section and many other causes, it can be assumed that this trend will continue to rise despite all the efforts to change it. This negative trend is also influenced by the decreasing willingness of obstetricians to “risk“ spontaneous labour in borderline obstetric situations. The growing number of caesarean sections increases the importance and influence of anaesthesia. As well as elsewhere in the world, we register the rise of regional anaesthesia in comparison to general anaesthesia in the past 20 years, so at present regional anaesthesia in caesarean delivery prevails. A review of the actual numbers however shows the alarming gap between the Czech Republic and the rest of the world. In 2011 regional anaesthesia for caesarean section was administered in 53% of cases and general anaesthesia in 47% in the Czech Republic. For comparison, general anaesthesia for caesarean section does not exceed 10–15% in most of the developed world. The causes include the conservatism of Czech obstetrics and the reluctance of obstetricians in many departments to regional anaesthesia techniques, but perhaps also the lack of availability of “local“ experiences published in the Czech medical journals. Therefore ESPAA in this article aims to summarize the current experience and recommendations for caesarean section under regional anesthesia to support the sites where some concerns to regional techniques still remain.

Keywords:
caesarean section – general anaesthesia – regional anaesthesia – choice of anaesthesia

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