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Awareness and practices regarding local anesthetic usage and toxicity among OB-GYN and anesthesiology professionals
Jumana Baaj1, Maysoon Alhaizan2, Reem Alsafar1
1Department of Anaesthesia, College of Medicine and King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia.
Background:
Local anesthetics (LAs) are commonly used in obstetrics and gynecology (OB-GYN); however, inappropriate administration can cause local anesthetic systemic toxicity (LAST), a life-threatening condition. For safe medical practice, healthcare providers should carefully follow the guidelines for administering LAs for early identification and proper management of LAST when it occurs.
Methods:
This nationwide study used a 36-item self-administered questionnaire administered to healthcare professionals in OB-GYN and anesthesiology. The survey assessed the knowledge, attitudes, and practices of commonly used LA agents, their appropriate dosage, and awareness of LAST's management.
Results:
A study of 391 Saudi healthcare professionals, between OB-GYN (51.2%) and anesthesiology (48.8%), reported greater engagement in anesthetic training and usage among anesthesiologists (88% trained, 58.1% daily use) than among OB-GYNs (38.5% trained, 30.5% daily use). OB-GYNs most commonly performed perineal tear repairs (88.5%), whereas anesthesiologists mainly performed paracervical blocks (89.5%). Lidocaine was the preferred local anesthetic for OB-GYNs at 93.5%, with anesthesiologists also favoring lidocaine but showing a higher use of bupivacaine (75.4%). Furthermore, the knowledge, attitudes, and practices scores of OB-GYN participants were significantly lower scores in all parameters compared to the anesthesiology participants (P < 0.001).
Conclusions:
Healthcare professionals in OB-GYN lack adequate knowledge of the safe and effective use of LA agents. Their knowledge must be increased through education to ensure safe practices.
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