A survey of obstetrical anaesthesia practice, teaching and research in canadian university departments of anaesthesia

Abstract

A report is presented of a questionnaire survey of obstetrical anaesthesia practice patterns, academic structure, resident teaching and research programmes in Canadian University Departments of Anaesthesia. Replies were received from 13 of the 16 departments, representing 24 university-affiliated hospitals. It is apparent that the majority of these hospitals do not have adequate obstetrical anaesthesia coverage. In most instances the delivery suite is covered by the anaesthetists on duty in the operating rooms. While epidural analgesia is widely used during labour, there are some hospitals where it still has a limited use, or is not used at all. Caesarean sections are still largely done under general anaesthesia in most reporting hospitals, with a few institutions reporting an increasing use of regional (mainly epidural) anaesthesia. Resident training in this branch of anaesthesia is felt to be deficient, based on the reports from many hospitals that resident staff are frequently not in attendance at deliveries; and on the evident failure in the majority of institutions to utilize their clinical material for teaching purposes. Research programmes in obstetrical anaesthesia are rare. The most common reason cited was the difficulty experienced in obtaining research funds. It is suggested that the major problems in obstetrical anaesthesia service, teaching and research are: 1. Economic, 2. Lack of interest, and 3. Lack of manpower. It is recommended that consideration be given to: 1. Consolidation of obstetrical services into larger units wherever practical. 2. Creation of more geographic full time appointments in obstetrical anaesthesia. 3. More efficient use of clinical material for teaching. 4. Development in individual hospitals of prenatal and public education programmes. © 1980 Canadian Anesthesiologists.