Anaesthesia praCtice for Caesarean dElivery Snapshot Study (ACCESS): Protocol and baseline characteristics of registered centres

C F Weiniger; N Brogly; A Lustig; O F C Van Den Bosch; P Kranke; N Lucas; E Morau; K Eklund; B Gunaydin; C Soledad Romero; A Afshari

doi:10.1111/aas.14427

Anaesthesia praCtice for Caesarean dElivery Snapshot Study (ACCESS): Protocol and baseline characteristics of registered centres

Acta Anaesthesiol Scand. 2024 Apr 26. doi: 10.1111/aas.14427. Online ahead of print.

Authors

C F Weiniger¹, N Brogly², A Lustig¹, O F C Van Den Bosch³, P Kranke⁴, N Lucas⁵, E Morau⁶, K Eklund⁷, B Gunaydin⁸, C Soledad Romero⁹, A Afshari⁷

Affiliations

¹ Division of Anesthesiology & Critical Care & Pain, Tel Aviv Sourasky Medical Center, affiliated with the Faculty of Medicine and Health Sciences, Tel Aviv University, Tel Aviv, Israel.
² Service of Anaesthesia and Intensive Care, La Paz University Hospital, Madrid, Spain.
³ Department of Anaesthesiology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands.
⁴ Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, University Hospital Würzburg, Würzburg, Germany.
⁵ Department of Anaesthesia, London North West University Healthcare NHS Trust, London, UK.
⁶ Department of Anaesthesiology Intensive Care and Perioperative Medicine, Clinical Epidemiology, Public Health, and Innovation in Methodology, CHU Nimes, University Montpellier, Nimes, France.
⁷ Department of Paediatric and Obstetric Anaesthesiology, Juliane Marie Centre, Rigshospitalet & Institute of Clinical Medicine, University Hospital of Copenhagen, Copenhagen, Denmark.
⁸ Department of Anesthesiology & Reanimation, Gazi University Faculty of Medicine, Ankara, Turkey.
⁹ Department of Anaesthesia, Intensive Care and Pain Medicine, University General Hospital of Valencia, Methodology Department, European University of Valencia, Valencia, Spain.

PMID: 38669012
DOI: 10.1111/aas.14427

Abstract

Background: Specific guidelines to manage caesarean delivery anaesthesia are lacking. A European multicentre study, ACCESS investigates caesarean delivery anaesthesia management in European centres. In order to identify ACCESS participating centres, a registration survey was created.

Objective: The aim of the current report is to describe the characteristics of ACCESS study participating centres, the rationale for the ACCESS study and the study methodology.

Design and setting: The ACCESS study is a European multicentre cross-sectional study to describe anaesthesia management for caesarean delivery (CD) using a snapshot (2-week) design. The ACCESS registration survey gathered: contact details for National Coordinators (NC); Lead Investigators (LI) per centre; centre annual CD volume; expected no. of CD during 2-week snapshot window; centre practice information; data collection language. The ACCESS registration survey was launched July 2022 (Google Forms, Google Inc., Mountain View, CA, USA) and distributed through personal connections, national and international societies, social media networks, during Euroanaesthesia 2023, through the European Society of Anaesthesiology and Intensive Care newsletter.

Results: The ACCESS registration survey identified Lead Investigators for 418 centres, in 32 countries, representing an anticipated number of 15,073 CD cases over the planned 12-month study period. A median (range) of 20 (2 to 400) CD cases are anticipated per centre during the 2-week snapshot window. Most 366/418 (87.6%) centres are small, ≤2000 annual CD cases, 42 are medium 2000-5000 cases and 10 are large, ≥5000 annual CD cases. Registered centres reported in 134 (32.0%) centres that anaesthesia for caesarean delivery is performed mostly by a specialist obstetric anaesthesiologist.

Conclusion: The ACCESS registration survey revealed variability in volume and CD practice as well as training-levels and staffing among European countries. The ACCESS study (https://www.access-study.org/) aims to generate practice data to guide CD anaesthetic management strategies.

Keywords: anaesthesia; caesarean; general; neuraxial; practice.