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A survey of Serbian anesthesiologists’ use of regional anesthesia for labor analgesia and cesarean delivery.
Abstract Number: S-15
Abstract Type: Original Research
Introduction: Regional anesthesia (RA) is infrequently used for labor analgesia and for cesarean delivery (CD) in Serbia.1 Kybele is dedicated to improving childbirth care and since 2012, has conducted 3 visits to Clinical Center Vojvodina (CCV) for clinical training of anesthesia providers working at CCV. During the visit in September, 2014, a five day didactic and hands-on clinical training experience was offered to anesthesiologists from across Serbia. A survey of practitioners’ prior experience in OB RA techniques both during anesthesia residency and in practice within Serbia was performed.
Methods: Following the clinical training experience, a 6 item survey was given to all participants. Survey items included: years in practice following residency, hospital type (Serbian hospitals in smaller communities offer combined general surgical and OB services, while specialty hospitals in larger cities conduct either OB or surgical services), and experience using epidural analgesia (EA) for labor, spinal analgesia (SA) for labor, and RA for CD (categorized by: 0, <10, 10 – 50, >50 total career experiences).
Results: 18 Surveys were completed (See Chart 1). All participants were trained in Serbian teaching hospitals with Health Ministry approved anesthesia training programs. The use of OB RA increased with practitioner experience. Most of the experience in RA appears to have occurred after completion of residency among providers with less than 5 years’ experience; 7 of 9 reported no experience with EA for labor, all 9 reported no experience with SA for labor, and 5 of 9 reported no experience with RA use for CD. The use of EA for labor is low among practitioners in community hospitals regardless of years of experience. The use of SA for labor is low, although one anesthesiologist in practice for many years reported an extensive experience. The use of RA for C/S increased with practitioner experience, but a significant minority of persons with >10 yr practice reported limited experience.
Discussion: The survey found that experience in use of RA for obstetrics is low among trainees and practitioners. Kybele should specifically include anesthesia trainees during clinical education outreach experiences involving OB RA. Kybele should also work with the leadership of local residency programs to increase the exposure of anesthesia residents to regional techniques for L&D and CS.
Reference: 1. Petakovic,et al. Medciniska Revija 2011;3:233.