A national survey of obstetric anaesthesia guidelines in the UK

Abstract 

Background

In May 2005 the Obstetric Anaesthetists’ Association (OAA) and Association of Anaesthetists of Great Britain and Ireland published a document entitled Guidelines for Obstetric Anaesthetic Services. This survey investigated if standards recommended in this document were being met more than six months after its release.

Methods

An OAA-approved questionnaire was sent to all obstetric anaesthesia lead clinicians across the UK, using the OAA mailing database. Standards investigated were those in relation to anaesthesia for caesarean section and postnatal audit programmes. The availability of 14 recommended clinical guidelines within departments of obstetric anaesthesia was also investigated.

Results

The response rate for the national survey was 79.3%. Not all departments met the standards set out in the guidelines for anaesthesia for caesarean section with only 61.2% of obstetric units having consultant-led elective lists carried out independently of emergency procedures. Eighty percent of units surveyed had postnatal audit programmes in place but only 58.8% generated a regular report from such programmes. The clinical guidelines recommended for obstetric departments were available to varying degrees. Guidelines for haemorrhage, preeclampsia and difficult/failed intubation were available in all units but only 34.6% of units had all 14 recommended guidelines available.

Discussion

This national survey illustrates to what extent UK departments meet national guidelines for provision of obstetric anaesthesia services. It also highlights areas for improvement nationally and could be used by individual units to plan resources in the future.

Keywords: Obstetric anaesthesia, Standards, Postnatal audit, Guidelines