The use of continuous epidural anaesthesia in intensive care units in Poland

Introduction

The aim of the study was to estimate the range of use of epidural anaesthesia in Intensive Care Units. Our study is a part of a large questionnaire surveillance study aimed at estimation of the widespread of regional anaesthesia in Poland.

Methods

The questionnaire was sent to 376 hospitals for adults, of a patients bed quantity of 250 and more, or specialised in orthopaedics, thoracic surgery, heart surgery or gynaecology and obstetrics. Head of Department of Anaesthesiology was asked to answer over 75 questions regarding the use of regional anaesthesia in his hospital. In regard of epidural anaesthesia in Intensive Care questions included : the presence of epidural anaesthesia, duration of catheter persist, use of catheter tunnelization technique, and the most frequent indications for epidural anaesthesia application in Intensive Care Unit. General questions included: the percentage of regional anaesthesia in all procedures, and for how long time they perform regional anaesthesia.

Results

We have obtained 118 responses (31.36%), 13 from university hospitals, 70 from regional hospitals, 17 from district hospitals, and 18 from specialised centres. Regional anaesthesia made from 3.6% to 83.3% (median value 21.4%) of all anaesthetic procedures. Application of epidural anaesthesia in ICU was confirmed in 64 hospitals (54.24% respondents), in 10 hospitals the epidural anaesthesia was not performed at all, in 28 there wasn't any Intensive Care Unit. The main indications reported were: acute pancreatitis, postoperative pain treatment, chest trauma and severe trauma. Occasionally epidural anaesthesia was used in myocardial infarction, asthma, vascular changes in lower extremities and in cancer patients. The mean time of use of catheter was 7 days. Tunnelization of the catheter was widely used in ICU practice.

Conclusions

Epidural anaesthesia has a place in Intensive Care practice in Poland. The use of this technique is restricted by hospital habits and costs. It is used mainly in acute pancreatitis, postoperative pain treatment and trauma.