Anaesthesia for caesarean section in Germany. A survey

Aim of study: Goal of this survey is to give an overview of anaesthesia for caesarean section in Germany. Method: In 1994 and 1995, we sent a questionnaire to the chief-anaesthetists of all German hospitals with departments of gynaecology/obstetrics to find out the routine anaesthetic procedures for caesarean section. Results: We obtained data from 409 hospitals (response rate 46.4%) with 321,816 births - 50,123 of which were sections (mean caesarean section rate 16.6%). The mean general anaesthesia rate for elective caesarean sections was 66,5%, for non-elective sections 90,8%. The mean epidural anaesthesia rate for caesarean section was 22,6% and the mean spinal anaesthesia rate was 9,8%. For general anaesthesia most hospitals used antacids and/or histamine(2)-receptor antagonists (64,6% of responding hospitals). Anaesthesia was induced with intravenous barbiturates (82%), succinylcholine for intubation (98,2%) and no opioids before clamping of the cord (94,8%). For regional anaesthesia bupivacaine was the most common local anaesthetic (spinal 84,0%, epidural 96,8%). Opioids were added to local anaesthetics for epidural anaesthesia at 21,4% of the hospitals. Conclusions: General anaesthesia is the commonest practice for caesarean sections at German hospitals. Nowadays regional anaesthesia gains more importance compared to previous German surveys and in agreement with foreign data.