Labor analgesia in Czech Republic and Slovakia: a 2015 national survey

•Czech and Slovak international survey on labor analgesia praxis in November 2015.•Covering more than 70% centers and almost 90% of labors in Czech Republic.•All consecutive cases of labor analgesia in participating centers in detail.•Minimal differences between both countries in low incidence of epidural analgesia.•Very low incidence of labor analgesia serious complications in both countries. The purpose of this international survey was to describe the current practices and techniques of labor analgesia in the Czech Republic (CZE) and Slovakia (SVK). All Czech and Slovak departments that provide obstetric anesthesia were invited to participate in a one-month (November 2015) prospective study that monitored in detail all peripartum anesthetic procedures delivered by anesthesiologists. Participating centers recorded all data on-line in the CLADE-IS database (Masaryk University, CZE). The response rate was 71% (70 of 95 departments in CZE, 35 of 54 centers in SVK). Participating centers represented 87.7% of all births in CZE and 66.4% of all births in SVK during the study period. Analgesia for labor, administered by anesthesiologists, was recorded in 12.5% of deliveries (CZE 12.1%, SVK 13.4%). Epidural analgesia was used in most of the cases (CZE 97.2%, SVK 99.1%) whereas spinal (CZE 1.4%, SVK 0.9%) or combined spinal-epidural (CZE 0.5%, SVK 0.0%) and intravenous remifentanil analgesia (CZE 2.4%, SVK 0.0%) were used infrequently. One fifth of the labors with analgesia administered by anesthesiologists (CZE 20.2%, SVK 20.5%) terminated in cesarean section. Although labor analgesia was available in all Czech and Slovak obstetric centers, only a small proportion of parturients received an effective method of labor pain relief (regional or intravenous analgesia).