International journal of obstetric anesthesia · 2026
Spinal anaesthesia for caesarean delivery in India: a national cross-sectional survey of anaesthesiologists' practice (2025).
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Gupta Priyanka, Gupta Mayank, Grewal Anju
Аннотация
BACKGROUND: Spinal anaesthesia is the preferred anaesthesia technique for caesarean delivery, however, substantial variability exists in clinical practice. This survey aimed to evaluate current practice patterns for caesarean delivery across India and identify areas of consistency and variability in spinal anaesthesia practice.
METHODS: A cross-sectional, questionnaire-based web survey was conducted among anaesthesiologists practising obstetric anaesthesia across India in 2025. The survey (24 questions) collected information on respondent demographics and perioperative anaesthetic practices related to spinal anaesthesia for caesarean delivery. Comparisons were assessed using the Chi-square test or Fisher's exact test, as appropriate.
RESULTS: There were 407 participants (representing approximately 1% in India). Common answers included aspiration prophylaxis with a combination of drugs, use of a single 18G intravenous cannula, fluid coloading, use of a 25G Quincke needle, and intrathecal bupivacaine 10-12.5 mg without any adjuvant mostly. Mephentermine was the most commonly used vasopressor for managing spinal hypotension, oxytocin was the preferred uterotonic, and postoperative analgesia typically involved multimodal systemic analgesics with or without regional techniques. Practice varied based on years of experience.
CONCLUSION: This national survey demonstrated considerable heterogeneity in spinal anaesthesia practices for caesarean delivery among Indian anaesthesiologists, influenced by their clinician experience. Although several practices were consistent with international guidelines, important deviations persisted, particularly regarding the use of wedge for left uterine displacement, spinal needle selection, choice of vasopressor for spinal-induced hypotension, and intrathecal adjuvants. These findings underscore the need for wider dissemination of guidelines and improved standardisation to optimise obstetric anaesthesia practice and outcomes.
METHODS: A cross-sectional, questionnaire-based web survey was conducted among anaesthesiologists practising obstetric anaesthesia across India in 2025. The survey (24 questions) collected information on respondent demographics and perioperative anaesthetic practices related to spinal anaesthesia for caesarean delivery. Comparisons were assessed using the Chi-square test or Fisher's exact test, as appropriate.
RESULTS: There were 407 participants (representing approximately 1% in India). Common answers included aspiration prophylaxis with a combination of drugs, use of a single 18G intravenous cannula, fluid coloading, use of a 25G Quincke needle, and intrathecal bupivacaine 10-12.5 mg without any adjuvant mostly. Mephentermine was the most commonly used vasopressor for managing spinal hypotension, oxytocin was the preferred uterotonic, and postoperative analgesia typically involved multimodal systemic analgesics with or without regional techniques. Practice varied based on years of experience.
CONCLUSION: This national survey demonstrated considerable heterogeneity in spinal anaesthesia practices for caesarean delivery among Indian anaesthesiologists, influenced by their clinician experience. Although several practices were consistent with international guidelines, important deviations persisted, particularly regarding the use of wedge for left uterine displacement, spinal needle selection, choice of vasopressor for spinal-induced hypotension, and intrathecal adjuvants. These findings underscore the need for wider dissemination of guidelines and improved standardisation to optimise obstetric anaesthesia practice and outcomes.