Abstract
A questionnaire was designed to determine the type of personnel that provide obstetrical anaesthesia care and the techniques used in the provision of this care.
All seven hospitals with an obstetrical unit affiliated with the University of Toronto and seven community hospitals responded.
All anaesthetics were given by physicians. Ninety-two per cent of those in University affiliated hospitals and 63 per cent of those in the community hospitals had obtained their specialty qualification.
Standards for preoperative assessment and communication with the patients should be similar to those applied to patients receiving anaesthesia for other reasons. It was clear from our survey that pre-anaesthetic assessment of obstetrical patients differs from that advocated for other surgical patients.
For vaginal deliveries, epidural analgesia was clearly the preferred choice. Subarachnoid block was rarely used. The majority of anaesthetists did not use a Jest dose. Eleven per cent in University-affiliated hospitals and 50 percent in community hospitals sometimes conducted surgical anaesthesia without tracheal intubation for vaginal delivery. More than 60 per cent routinely encouraged their patients to accept general anaesthesia for Caesarean section. The doctors providing neonatal resuscitation may require further training.
Surveys such as this are important if standards of anaesthetic practice are to be established.
Résumé
Dans le but d’identifier le type du personnel qui administrait l’anesthé sie obsté tricale et les techniques utilisé es à cet effet, on a distribué un questionnaire auquel ont ré pondu tous les hôpitaux affilié s à l’Université de Toronto qui possé daient un dé partement d’obsté trique et sept hôpitaux communautaires.
Toutes les anesthé sies obsté tricales é taient administré es par des mé decins dont quatre-vingt douze pour cent possé daient des qualifications de spé cialiste dans les hôpitaux universitaires et soixante-trois pour cent dans les hôpitaux communautaires. Les standards reconnus en usage pour revaluation pré -anesthésique et les communications avec les patients devraient être les mêmes pour tous les patients qui reçoivent l’anesthé sie; or, il devint é vident que l’é valuation pré -anesthé sique des parturientes diffé rait de celle qu’on exige pour les autres patients.
Pour les accouchements, l’anesthé sie de choix a é té l’anesthé sie pé ridurale alors que l’anesthé sie sous-arachnoidienne é tait rarement utilisé e. La majorité des spé cialistes n’employaient pas de dose-test. Lors d’anesthé sie gé né rale pour accouchement, le trachée n’a pas é té intubé e dans onze pour cent des hôpitaux affilié s à l’Université et dans cinquante pour cent des hôpitaux communautaires. Plus de soixante pour cent des anesthé sistes ont suggé ré à leurs patientes d’accepter l’anesthé sie gé né rale pour la cé sarienne. Les mé decins qui pratiquaient la ré animation né onatale avaient besoin de formation plus avancé e. Des enquêtes comme celle-ci sont importantes si on veut maintenir à un niveau é levé les standards d’exercise de l’anesthésie.
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Hew, E.M., Rolbin, S.H., Cole, A.F.D. et al. Obstetrical anaesthesia practice in the university of toronto affiliated hospitals and some randomly selected community hospitals. Canad. Anaesth. Soc. J. 28, 158–166 (1981). https://doi.org/10.1007/BF03007261
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DOI: https://doi.org/10.1007/BF03007261