A survey of obstetric anesthesia practices in Flanders - 10 year update

We assessed the practice of obstetric anesthesia in Flanders through an on-line enquiry form and investigated the advancements by comparing the results with those of the 2004 survey. 54 (86%) structured forms were completed, representative for 94% of the accredited maternity beds in Flanders. Obstetric anesthesia is provided in all Flemish acute hospitals and 7/10 deliveries are performed nowadays with neuraxial analgesia. For labor analgesia, classical epidural remains the main neuraxial technique (62%) whereas CSE is used as default technique in 17% of the hospitals and upon indication in 21%. In half of the departments a test dose is used to validate the correct placement of the catheter, with lidocaine as the most (68%) commonly used test drug; this practice is comparable to 10 years ago. Ropivacaine (84%) with or without sufentanil is typically used as loading dose and ropivacaine with sufentanil (83%) to maintain the epidural analgesia. Patient-controlled epidural analgesia is the preferred maintenance mode (76%) for labor analgesia. CSE with hyperbaric bupivacaine and sufentanil is the most used anesthesia protocol when caesarean section is required (47%). There is no clear preference for postoperative analgesia after cesarean section as both epidural/regional and parenteral/per os analgesia regimens are almost equally used in Flemish obstetric care.