National survey on clinical practice in obstetric analgesia in Spain

A national survey was conducted among maternity hospitals nationwide to understand the variability in clinical practice for obstetric analgesia and to reach a consensus on optimal care in the future in Spain. Spanish experts in obstetric anesthesiology designed a survey on the practice of obstetric analgesia during childbirth, following a Delphi process. The survey was sent to 195 Spanish maternity hospitals between April and September 2022 using Google Forms. A descriptive study of the results was performed. Responses were obtained from 108 centres (55.4%), of which 88 (83.8%) were public hospitals. The most commonly used technique was epidural analgesia in 97 (92.4%) centres. Nine (8.6%) centres used the combined spinal-epidural (CSE) technique, 5 (4.8%) used spinal analgesia, and 3 (2.9%) used dural puncture epidural (DPE) analgesia. The most commonly used local anaesthetic was levobupivacaine 0.1−0.25% in 82 (78.1%) centres. Fentanyl or sufentanil were added to the local anaesthetic in 96 (91.4%) centres. Epidural maintenance was performed with continuous epidural infusion (CEI) + patient-controlled epidural analgesia (PCEA) or programmed intermittent epidural bolus (PIEB) + PCEA in 64 (60.9%) and 33 (30.5%) centres, respectively. Fifteen (14.3%) centres lacked alternative techniques to epidural analgesia and 25 (23.8%) did not follow obstetric analgesia protocols. Despite the variability in clinical practice for obstetric analgesia in Spain, the vast majority of centres follow recommendations in this field. There is room for improvement, which should be considered a fundamental strategy for progressing towards excellence. Se llevó a cabo una encuesta nacional entre las maternidades del territorio español para conocer la variabilidad de la práctica clínica en analgesia obstétrica y consensuar un óptimo cuidado futuro en España. Expertos españoles en anestesiología obstétrica, diseñaron una encuesta sobre la práctica de la analgesia obstétrica durante el parto, siguiendo un proceso Delphi. La encuesta fue enviada a 195 maternidades españolas entre abril y septiembre de 2022 utilizando Googleform. Se realizó un estudio descriptivo de los resultados. Se obtuvieron respuestas de 108 centros (55.4%), de los que 88 (83.8%) fueron hospitales públicos. La técnica más utilizada fue la analgesia epidural en 97 (92,4%) centros. Nueve (8,6%) centros usaban la técnica espinal-epidural combinada (CSE), 5 (4,8%) la analgesia espinal y 3 (2,9%) la analgesia epidural c