Practice of epidural analgesia for labour pain: a German survey

Epidural analgesia is one of the preferred methods of analgesia for labour. The aim of the present survey was to evaluate current practice in obstetri c analgesia in departments of anaesthesia and to make a comparison with for mer surveys from Germany and other countries. Questionnaires on the practic e of pain relief, especially epidural analgesia, during labour and delivery were sent to 1178 anaesthesic departments in Germany in the second half of 1996. Five hundred and thirty-two completed replies were received, which r epresent 46.9% of all German obstetric units. The majority of the departmen ts of anaesthesia practising epidural analgesia have an epidural rate of le ss than 10% and 10.2% of the departments do not offer this method to their parturients. In 86.8% of all units performing epidural analgesia, the epidu ral catheter is placed by an anaesthetist. Only 6.5% of the units provide a 24-h epidural service which is exclusively assigned to labour and delivery . In 77.8% of the units, this service is not exclusively assigned to obstet rics, but also to other duties. Of the obstetric units offering epidural an algesia, 14.7% have no epidural service at night. Plain local anaesthetics for epidural analgesia are used by 55.9% of the departments, a combination of local anaesthetics with epidural opioids by 28.7%. Epidural analgesia is predominantly (82.2%) maintained by intermittent bolus administration. Alt hough the rate of epidural analgesia increased during recent decades, this method is not offered to all parturients. Further improvements in the use o f epidural analgesia for labour seem to be necessary.