Choice of anaesthetic agents for caesarean section: A UK survey of current practice

BackgroundA national survey of current practice and preferred drug choices for both induction and maintenance of general anaesthesia for caesarean section was undertaken.MethodsFollowing approval by the Obstetric Anaesthetists’ Association, all UK consultant members were invited to respond to an electronic survey.ResultsThe response rate was 56% (691/1228). Ninety-three percent of respondents use thiopental for induction: 58% (15% definitely and 44% probably) would support a change to propofol for induction. Thiopental was used in most cases for historical reasons (37%) or to reduce awareness (31%); other considerations included a clear end-point, dose predictability, cardiovascular stability, effects on the baby and drug licence concerns. Fifty-seven percent indicated that their trainees were encouraged to use thiopental for non-obstetric anaesthesia. Fifteen percent of respondents use opioids during rapid-sequence induction. Eighty-five percent use nitrous oxide; 53% of respondents use sevoflurane (51.6%) or desflurane (1.6%) for maintenance of anaesthesia, and this would increase to over 80% if financial constraints were removed.ConclusionOur survey suggests that while thiopental remains the induction agent of choice in the UK, a reasonable body of medical opinion would support a change to propofol for induction. This is reassuring as thiopental becomes more difficult and expensive to obtain.