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General anesthesia for cesarean delivery: Israeli national survey
Daniel Shatalin1, Yair Binyamin2, Jacob Weinstein3
1Department of Anesthesiology, Perioperative Medicine and Pain Treatment, Shaare Zedek Medical Center affiliated with The Hebrew University, Jerusalem, Israel. danielsmail@gmail.com.
Journal of Anesthesia, Analgesia and Critical Care
|July 2, 2025
Summary
This national survey highlights variations in general anesthesia practices for cesarean delivery. Key findings include underuse of anesthesia depth monitoring and suboptimal postoperative pain control, emphasizing the need for qualified personnel and standardized protocols.
Area of Science:
- Anesthesiology
- Obstetrics
- Surgical Safety
Background:
- Cesarean delivery is a common global surgery.
- General anesthesia is sometimes necessary but carries risks.
- A national survey investigated general anesthesia practices in cesarean deliveries.
Purpose of the Study:
- To assess current practices and identify areas for improvement in general anesthesia for cesarean delivery.
- To evaluate the use of specific anesthetic techniques, monitoring, and pain management strategies.
- To understand the availability of resources like difficult airway algorithms and equipment.
Main Methods:
- A multicenter national survey of 25 medical centers with obstetric anesthesia units.
- Questionnaires covered preoperative management, personnel, anesthetic phases, pain control, protocols, and complications.
- Data collected from October 2020 to March 2021 from 113 participants.
Main Results:
- 88.5% used routine pharmacological aspiration prophylaxis.
- Only 23.9% ventilated patients during rapid sequence induction (RSI).
- Routine anesthesia depth monitoring (18.6%) and postoperative patient-controlled analgesia (5.3%) were underused.
Conclusions:
- Qualified anesthesiologists, short-acting opiates, videolaryngoscopes, and ventilation during RSI are crucial.
- Institutional difficult airway protocols are important.
- Underuse of intraoperative monitoring and poor postoperative pain control require attention.
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