Obstetrical anesthesia – Czech Republic versus world

Czech version

Authors: Jan Bláha
Authors‘ workplace: Expertní skupina porodnické anestezie a analgezie při ČSARIM ; Klinika anestezie, resuscitace a intenzivní medicíny 1. LF UK a VFN, Praha, přednosta doc. MUDr. Martin Stříteský, CSc.
Published in: Prakt Gyn 2013; 17(4): 287-292
Category: Gynecology and Obstetrics: Review Article

Overview

In the Czech Republic nearly a one quarter of all births ends with Caesarean section and it is supposed that the tendency will continue to rise despite of all efforts done, due to the increasing age of mothers, their higher morbidity, increasing number of states after previous Caesarean section and many other causes. Undoubtedly it is partly due to reduced willingness of obstetricians to risk spontaneously managed delivery in uncertain obstetric situations. Increasing number of Caesarean sections increases importance and influence of administered anesthesia. Similarly as in the world, we have noticed continuos rise of the use of regional anesthesia compared with general anesthesia in our records from the last 20 years, so nowadays it prevails. All previously mentioned looks good. If we look at statistical data it shows an alarming gap between the Czech Republic and the rest of the world. In 2011 in the Czech Republic 53% of Caesarean sections were performed under regional anesthesia and 47% under general anesthesia. Just for comparison, in mostly medically developed countries, the use of general anesthesia for Caesarean section does not exceed 15%! We can find the reason of that mainly in the rigidity and conservatism of Czech obstetrics and in aversion to regional anesthetic techniques in many centers which is difficult to understand. Therefore, this article tries to explain the reasons for the worldwide preference of regional anesthesia for Caesarean section and thus encourage the centers where the regional techniques still represent source of useless doubts.

Key words:
Caesarean section – choice of anesthesia – general anesthesia – obstetrical anesthesia – regional anesthesia

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