COMPARISON OF OBSTETRIC ANESTHESIA PRACTICES IN DIFFERENT LEVEL OF HOSPITALS ACROSS PAKISTAN

Abstract

Objective: To compare the current practices in obstetric anesthesia in different level of hospitals across Pakistan and their adherence to guidelines and standards. Study Design: Cross sectional analytical study. Place and Duration of Study: Department of Anesthesiology, Combined Military Hospital Okara for two months, from Dec 2018 to Feb 2019. Material and Methods: Five hundred questionnaire were sent to Department of Anesthesiology of 100 different hospitals. The proforma was a self-administered 22-questions that asked about the various aspects of the conduct of obstetric anesthesia. The data were analyzed using SPSS version 20. The qualitative variables were presented as frequency and percentage. Chi square used to calculate significance; p-value ≤0.05 taken as significant. Results: We received 311 questionnaires (62.2%) from various institutes. At the tertiary care hospital, most of respondents were aged less than 35 years and had an experience of 11-20 years as compared to 35-50 years in primary and secondary care hospitals; p<0.01. Although males (68.5%) make up a bulk of anesthetist, most of the females were working in tertiary care hospitals, p-value<0.01. Most of the obstetric anesthesia practices were comparable between the levels of hospitals. Anesthetist at tertiary care hospitals more commonly used colloid preload; a lesser volume for preload; routine left uterine tilt, prophylactic vasopressors and epidural analgesia for painless labor in obstetric anesthesia practices, p<0.05. Conclusion: Most the obstetric anesthesia practices were comparable between the three levels of hospital. These are in accordance with the latest guidelines by international societies.

Keywords

• epidural for painless labor
• local anesthetic dose
• obstetric anesthesia
• prophylactic vasopressor