Current practice in postoperative epidural analgesia: a german survey

Area of Science:

• Anesthesiology
• Pain Management
• Health Services Research

Background:

• Postoperative pain management is crucial for patient recovery.
• Epidural analgesia (EA) is a common method for managing postoperative pain.
• Understanding current practices in EA is essential for quality improvement.

Purpose of the Study:

• To survey current German practices in postoperative epidural analgesia.
• To assess the availability of 24-hour acute pain services (APS) in German hospitals.
• To identify common local anesthetic (LA) agents, concentrations, and opioid combinations used in EA.

Main Methods:

• An anonymous questionnaire was distributed to 300 German hospitals.
• 147 (49%) questionnaires were completed and analyzed.
• Data on APS availability, LA/opioid use, and EA administration methods were collected.

Main Results:

• 41% of German hospitals offer a 24-hour APS, with higher availability in large teaching hospitals.
• Ropivacaine and bupivacaine were the most common local anesthetics, with differing preferences based on hospital size.
• 64% of respondents used a combination of LA and opioids for EA in the general ward setting.
• Continuous epidural infusion was the most frequent administration method (58%).

Conclusions:

• The availability of 24-hour APS in German hospitals is comparable to international data.
• Combining local anesthetics with opioids is the predominant method for epidural analgesia in German wards.
• Hospital size influences the choice of local anesthetics and the provision of APS.