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REGIONAL ANESTHESIA

Current Practice in Postoperative Epidural Analgesia: A German Survey

Sandra Kampe, MD^*, Peter Kiencke, PhD, Jens Krombach, MD, Karen Cranfield, FRCA, Stefan Mario Kasper, MD^*, and Christoph Diefenbach, MD^*

Departments of *Anesthesiology and Intensive Care Medicine and Medical Statistics, University of Cologne, Cologne, Germany; Department of Anesthesiology, University of California-San Francisco, San Francisco, California; and Department of Anesthesiology, Aberdeen Royal Infirmary, Aberdeen, Scotland

Address correspondence and reprint requests to Sandra Kampe, MD, Department of Anesthesiology and Intensive Care Medicine, University of Cologne, Joseph-Stelzmann-Str. 9, 50931 Cologne, Germany. Address e-mail to sandra.kampe{at}medizin.uni-koeln.de

We surveyed current German practice in postoperative epidural analgesia (EA). Of 300 questionnaires sent anonymously, 147 (49%) were returned fully completed. A 24-h acute pain service (APS) was offered in 41% of German hospitals. Seventy percent of the large teaching hospitals (>1000 beds) offered an APS, whereas just 9% of the hospitals of <500 beds provided an APS. Small-size hospitals (<200 beds) preferred ropivacaine as the local anesthetic (LA) in contrast to large teaching hospitals using more bupivacaine than ropivacaine. In the general ward setting, 36% of the respondents used plain LA, and 64% combined the LA with an opioid. If ropivacaine was used, 0.2% was the most popular concentration (78%), combined with morphine (17%), fentanyl (14%), or sufentanil (75%). If bupivacaine was used, 0.25% was the preferred concentration (30%), combined with morphine (40%), fentanyl (8%), or sufentanil (60%). On wards, 58% of German anesthetic departments used continuous epidural infusion, 57% bolus doses, and 20% patient-controlled EA mode. We conclude that the availability of a 24-h APS (41%) in German hospitals corresponds favorably to international data. EA with the combination of LAs and opioids was the most common modality in the ward setting.

IMPLICATIONS: We surveyed current German practice in postoperative epidural analgesia. We found that the availability of a 24-h acute pain service (41%) in German hospitals corresponds favorably to international practice. Epidural analgesia with the combination of local anesthetics and opioids was the most common modality in the ward setting.

This article has been cited by other articles:

				U. M. Stamer and F. Stuber Postoperative Epidural Analgesia: How About Quality Assessment? Anesth. Analg., September 1, 2003; 97(3): 918 - 919. [Full Text] [PDF]