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Canadian Journal of Anesthesia/Journal canadien d'anesthésie

Erschienen in:

13.11.2023 | Reports of Original Investigations

Anesthesia practice for Cesarean delivery in Japan: a retrospective cohort study

verfasst von: Hiroshi Yonekura, MD, MPH, PhD, Yusuke Mazda, MD, PhD, Shohei Noguchi, MD, PhD, Hironaka Tsunobuchi, MD, PhD, Koji Kawakami, MD, PhD

Erschienen in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie | Ausgabe 2/2024

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Abstract

Purpose

General anesthesia for Cesarean delivery affects maternal and neonatal outcomes. We aimed to evaluate temporal trends in anesthesia management for Cesarean deliveries over 16 years and analyze interinstitutional variations in general anesthesia use in Japan.

Methods

In this retrospective cohort study, we obtained patient data from the nationwide health insurance claims database containing data for ten million individuals. We included patients who underwent Cesarean delivery between 1 January 2005 and 31 August 2021. The primary outcome was the use of general anesthesia. We evaluated institutional variations in general anesthesia use in medical facilities using two-level hierarchical logistic regression analyses with median odds ratios and intraclass correlation coefficients.

Results

The cohort included 86,793 patients who underwent 102,617 Cesarean deliveries at 2,496 institutions. General anesthesia was used in 3.7% (95% confidence interval [CI], 3.6 to 3.9) of all Cesarean deliveries. The temporal trend in the use of general anesthesia decreased gradually from 10.8% in 2005 to 2.9% in 2021 (P for trend < 0.001). The adjusted median odds ratio for medical facilities was 6.1 (95% CI, 5.9 to 6.7), and the intraclass correlation coefficient was 0.52 (95% CI, 0.51 to 0.55).

Conclusion

Although the rate of general anesthesia use for Cesarean delivery in Japan decreased gradually from 2005 to 2021, general anesthesia was used in 3.7% of all Cesarean deliveries. The use of general anesthesia varied significantly across institutions, and 52% of the overall variations in general anesthesia practice can be explained by differences between facilities.

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Titel: Anesthesia practice for Cesarean delivery in Japan: a retrospective cohort study
verfasst von: Hiroshi Yonekura, MD, MPH, PhD
Yusuke Mazda, MD, PhD
Shohei Noguchi, MD, PhD
Hironaka Tsunobuchi, MD, PhD
Koji Kawakami, MD, PhD
Publikationsdatum: 13.11.2023
Verlag: Springer International Publishing
Erschienen in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie / Ausgabe 2/2024
Print ISSN: 0832-610X
Elektronische ISSN: 1496-8975
DOI: https://doi.org/10.1007/s12630-023-02633-w

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Anesthesia practice for Cesarean delivery in Japan: a retrospective cohort study