Document Detail

Contraindications to regional anaesthesia in obstetrics: a survey of German practice.
MedLine Citation:
PMID:  17698339     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: We assessed current practice regarding indications and contraindications to regional analgesia and anaesthesia for labour and delivery in Germany. METHODS: Questionnaires were mailed to the directors of 918 German departments of anaesthesiology. RESULTS: A total of 397 completed replies were received representing 41.3% of all deliveries in Germany. More than half of the respondents never perform spinal or epidural anaesthesia when the platelet count falls below 65x10(9)/L. Preeclampsia, which was not graded for severity, was considered an absolute contraindication to regional block by 15% and placenta praevia by 30% of respondents. If a woman had taken aspirin three days before, the numbers of respondents considering epidural anaesthesia contraindicated (40.2%) were nearly double those considering spinal anaesthesia contraindicated (21.7%) (P<0.001). For a platelet count of 79x10(9)/L, epidural anaesthesia was thought to be contraindicated by 37% and spinal anaesthesia by 22.2% (P=0.001). In departments with <500 deliveries/year, reluctance to use regional blockade was more pronounced than in departments with >1000 deliveries/year. CONCLUSION: Clinical practice varies considerably in Germany. Concerns regarding the use of regional blockade were more prevalent in hospitals with small delivery units. Indications and contraindications are not consistent in Germany and some recommendations or guidelines are needed.
U M Stamer; F Stuber; R Wiese; H Wulf; T Meuser
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Publication Detail:
Type:  Journal Article     Date:  2007-08-14
Journal Detail:
Title:  International journal of obstetric anesthesia     Volume:  16     ISSN:  0959-289X     ISO Abbreviation:  Int J Obstet Anesth     Publication Date:  2007 Oct 
Date Detail:
Created Date:  2007-09-17     Completed Date:  2007-12-31     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9200430     Medline TA:  Int J Obstet Anesth     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  328-35     Citation Subset:  IM    
Department of Anaesthesiology and Intensive Care Medicine, University of Bonn, Germany.
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MeSH Terms
Anesthesia Department, Hospital / standards*
Anesthesia, Conduction / contraindications*,  utilization
Anesthesia, Epidural / contraindications,  utilization
Anesthesia, Obstetrical / contraindications*,  utilization
Health Care Surveys*
Obstetrics / standards*
Physician's Practice Patterns / statistics & numerical data*
Pregnancy Complications

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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