• H Wulf and U Stamer.
• Klinik für Anaesthesiologie und Operative Intensivmedizin, Christian-Albrechts-Universität Kiel.
• Anaesthesist. 1998 Jan 1;47(1):59-63.

UnlabelledObviously there is a world-wide trend towards regional anaesthesia for caesarean section (CS). Data on the current practice in Germany are lacking.MethodsIn 1996 questionnaires on obstetric anaesthesia were mailed to all University departments of anaesthesia.ResultsAll 38 University Hospitals with obstetric units replied (100%). Mean annual delivery rate was 1156 with a mean CS-rate of 24%. For scheduled CS the University departments used general anaesthesia in most cases (60%), followed by epidural (31%) and spinal anaesthesia (9%). General anaesthesia was predominantly used for more urgent (87%) or emergency deliveries (99%). Spinal anaesthesia was offered to patients as an option of anaesthesia for CS in 16 of 38 departments, epidural anaesthesia in 36 of 38. The majority of university hospitals (22 of 38) performed more than 25% of their CS in epidural anaesthesia; 14 departments had a ratio of at least 50% of regional anaesthesia. 28 of 32 centres administered some kind of acid aspiration chemoprophylaxis as a routine management. Special devices for the management of a difficult airway were provided in 61% of the hospitals within the delivery unit. In 70% the anaesthesiologist was responsible for the postoperative pain management following CS.ConclusionA significant trend towards regional anaesthesia for CS has taken place in German university hospitals: According to a former survey regional anaesthesia was used in less than 10% of CS in 1977, whereas in the current evaluation from 1996 this figure was significantly higher (40%). Nevertheless, compared to other countries the rate of general anaesthesia still is rather high.

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