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Online ISSN 1827-1596
Gruppo di Lavoro e Clinici di Riferimento Gisapo
Azienda «Istituti Ospedalieri» - Cremona, Servizio di Anestesia e Terapia Intensiva;
Istituto di Ricerche Farmacologiche Mario Negri, Laboratorio di Epidemiologia Clinica - Milano;
Istituto Nazionale per la Ricerca sul Cancro - Genova, Dipartimento di Anestesia e Terapia Intensiva
Background. To describe the use of anesthesia and postoperative analgesia techniques in Italy, with a geographical comparison.
Methods. Randomized selection—stratified by region—of 395 Departments of Anesthesia and Intensive Care (DAIC). With a personal, anonymous questionnaire developed ad hoc, we tried to point out the differences in five Italian geographical areas (North-East NE; North-West NW; Centre-North CN; Centre-South CS; South S) for demographic, organizational, attitudinal variables as well as the use of anesthesia and post-operative analgesia techniques (drugs and routes of administration).
Results. The response rate was 78.9% (312 centres in 293 hospitals) with 2,435 analyzable questionnaires. Demographic data: the anesthetists in CS and S are the oldest ones and they carry out a low number of anesthesia per week. Only 13% of the CS anesthetists work in a fixed surgical speciality. Anesthesia techniques: general anesthesia (GA) is the most frequently used in all five groups. Extensive use of GA is made in NW (68%) while CS and NE use with high frequency the spinal/epidural techniques (both 24%). NE has the greatest frequency (7.4%) of combined anesthesia (GA+ S/Ep.). Postoperative analgesia (POA): the intramuscular way (i.m.) is the most used route in all groups, except for CS. Nonsteroidal antinflammatory drugs (NSAIDs) are preferred to opioids for both i.m. and i.v. route. Epidural analgesia (EA) is frequently used in CS and NE. Local anesthetics-opioids association (LA+Op) is preferred for the epidural analgesia administration; only the colleagues of S use this association and LA only in similar percentage (10.7% vs 8.2%).
Conclusions. CS and NE are the most active Italian geographical areas in intraoperative application of locoregional anaesthesia techniques as well as in postoperative epidural analgesia.