Hostname: page-component-cd9895bd7-gvvz8 Total loading time: 0 Render date: 2024-12-19T10:48:32.017Z Has data issue: false hasContentIssue false
  • English
  • Français

Current practice in regional anaesthesia in Germany

Published online by Cambridge University Press:  27 January 2006

F. Heid ,
B. Jage  and
J. Jage
F. Heid
Affiliation:
Johannes Gutenberg University, Department of Anaesthesiology, Mainz, Germany
B. Jage
Affiliation:
Johannes Gutenberg University, Department of Anaesthesiology, Mainz, Germany
J. Jage
Affiliation:
Johannes Gutenberg University, Department of Anaesthesiology, Mainz, Germany
Get access

Extract

Summary:

Background and objective: Several new techniques and agents (e.g. ropivacaine) have been introduced in regional anaesthesia to improve patients outcome and safety. The beneficial effects on patient outcome are clear with these techniques, however, no information is available about their pattern and frequency of use in clinical practice. This study presents data concerning the current practice of regional anaesthesia in Germany. Methods: A questionnaire was sent to every German anaesthesia department (n = 1381). Questions focused on the frequency and range of regional anaesthetic procedures employed, with attention also to the organizational structural of the individual institution. Results: Six hundred and sixty-seven questionnaires were returned anonymously, representing a return rate of 48.3%. In hospitals with less than 200 beds, the number of regional anaesthetics was markedly higher compared to large hospitals with more than 400 beds. In contrast, small hospitals tended to provide only basic techniques of regional anaesthesia, whereas larger hospitals implemented more advanced techniques. Bupivacaine remains the most commonly used long-lasting local anaesthetic. Staff structure was also different in small departments – patient care was performed by board certified anaesthesiologists while residents were responsible for the patients in larger departments. Conclusions: In small hospitals a majority of board certified anaesthesiologists rely on basic regional anaesthesia techniques. In large departments some consultants provide the entire spectrum of regional anaesthesia, with the majority of cases transferred to the residents responsibility. These results indicate the strong need to improve residency programs with regard to regional anaesthesia.

Keywords

regional anaesthesia and analgesia, education and training
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 23 , Issue 4 , April 2006 , pp. 346 - 350
Copyright
© 2006 European Society of Anaesthesiology

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Pavlin DJ, Rapp SE, Polissar NL et al. Factors affecting discharge time in adult outpatients. Anesth Analg 1998; 87: 816–826.Google Scholar
Williams BA, Kentor ML, Vogt MT et al. Economics of nerve block pain management after anterior cruciate ligament reconstruction: potential hospital cost savings via associated postanesthesia care unit bypass and same-day discharge. Anesthesiology 2004; 100: 697–706.Google Scholar
Mather LE, Chang DH. Cardiotoxicity with modern local anaesthetics: is there a safer choice? Drugs 2001; 61: 333–342.Google Scholar
Kehlet H, Holte K. Effect of postoperative analgesia on surgical outcome. Br J Anaesth 2001; 87: 62–72.Google Scholar
Rodgers A, Walker N, Schug S et al. Reduction of postoperative mortality and morbidity with epidural or spinal anesthesia: results from overview of randomized trials. BMJ 2000; 321: 1493–1497.Google Scholar
Auroy Y, Benhamou D, Bargues L et al. Major complications of regional anesthesia in France. Anesthesiology 2002; 97: 1274–1280.Google Scholar
Clergue F, Auroy Y, Pequignot F et al. French survey of anesthesia in 1996. Anesthesiology 1999; 91: 1509–1520.Google Scholar
Kopacz DJ, Neal JM, Pollock JE. The regional anesthesia ‘learning curve’. Reg Anesth 1996; 21: 182–190.Google Scholar
Konrad C, Schüpfer G, Wietlisbach M et al. Learning manual skills in anesthesiology: is there a recommended number of cases for anesthetic procedures? Anesth Analg 1998; 86: 635–639.Google Scholar
Bundesärztekammer, 2004. http://www.bundesaerztekammer.de/30/Weiterbildung/04MRi.pdf.
Hargett MJ, Beckman JD, Liguori GA, Neal JM. Guidelines for regional anesthesia fellowship training. Reg Anesth Pain Med 2005; 30: 218–225.Google Scholar
Kopacz DJ, Neal JM. Regional anesthesia and pain medicine: residency training – the year 2000. Reg Anesth Pain Med 2002; 27: 9–14.Google Scholar
Neal JM, Kopacz DJ, Liguori GA, Beckman JD, Hargett MJ. The training and careers of regional anesthesia fellows 1983–2002. Reg Anesth Pain Med 2005; 30: 226–232.Google Scholar
Bartussek E, Fatehi S, Motsch J et al. Survey on practice of regional anaesthesia in Germany, Austria, and Switzerland. Part 1: Quality assurance and training concepts. Anaesthesist 2004; 53: 836–846.Google Scholar
Bouaziz H, Mercier FJ, Narchi P, Poupard M, Auroy Y, Benhamou D. Survey of regional anesthetic practice among French residents at time of certification. Reg Anesth 1997; 22: 209–211.Google Scholar
Clergue F, Auroy Y, Pequignot F, Jougla E, Lienhart A, Laxenaire MC. Evolution of the anaesthetic workload – the French experience. Best Pract Res Clin Anaesthesiol 2002; 16: 459–473.Google Scholar