TOPLINE

General anesthesia was used in 14.8% of cesarean deliveries across 31 European countries, with use about five-fold higher in emergency than in elective cases; practice varied widely across countries.

METHODOLOGY

• Researchers conducted a prospective cohort study to describe patterns of use of general anesthesia for cesarean deliveries across European countries and how use varied by urgency.
• They included 9989 cesarean deliveries at 361 centers across 31 European countries, with each center collecting cases during a 2-week period between September 2023 and April 2025.
• The urgency of cesarean deliveries was classified as emergency, urgent, expedited, or elective.
• The primary outcome was the frequency of cesarean deliveries performed under general anesthesia for each category of urgency.
• Secondary outcomes included the use of neuraxial anesthesia at each level of urgency, rates of conversion from neuraxial to general anesthesia, and the reasons for choosing or switching to general anesthesia.

TAKEAWAY

• General anesthesia was used in 14.8% of cesarean deliveries and was most common in emergency cases (54.0%), followed by urgent (13.8%), expedited (11.3%), and elective (10.9%) cases.
• Neuraxial anesthesia was initially planned for 92.4% of deliveries. Of these, 7.7% were converted to general anesthesia, most often in emergency cases (23.1%).
• For initial general anesthesia, the top reason was maternal request in elective cases (47.0%) and emergent need in emergency cases (58.4%).
• The median decision-to-delivery times ranged from 13 minutes for emergency cases to 58 minutes for expedited cases. Rates of general anesthesia ranged from below 5% in Bulgaria and Wales to more than 30% in Slovakia and Serbia.

IN PRACTICE

"Although these data cannot guide individual patient management, they identify areas for future audits and data collection, including urgency classification, supplementary medication, patient-reported outcomes, and conversion to GA [general anesthesia], particularly among elective cases where time permits optimisation of neuraxial anaesthesia," the researchers reported.

SOURCE

The study was led by Carolyn F. Weiniger of Tel Aviv University in Tel Aviv, Israel. It was published online on October 9 in the British Journal of Anaesthesia.

LIMITATIONS

Researchers did not collect any patient-reported outcomes. Inconsistent entry of data and categorization across centers may have misclassified certain cases. Data on the reasons for using general anesthesia were missing for up to 14% of cases.

DISCLOSURES

Funding information was not provided for the study. The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.