The disappearing art of obstetric general anaesthesia in the UK: implications for overseas trainees

Abstract

We read with interest the recent editorial by Lipman et al. revisiting the subject of the near total demise of obstetric general anesthesia. [1] Lipman S. Carvalho B. Brock-Utne J. The demise of general anesthesia in obstetrics revisited: prescription for a cure. Int J Obstet Anesth. 2005; 14: 2-4 Abstract Full Text Full Text PDF PubMed Scopus (41) Google Scholar The relentless decline in the use of general anaesthesia for caesarean section in the UK is due to the clear downward trend of maternal mortality with increasing use of obstetric regional anaesthesia and decrease in the use of general anesthesia. [2] Jenkins J.G. Khan M.M. Anaesthesia for caesarean section: a survey in a UK region from 1992 to 2002. Anaesthesia. 2003; 58: 1114-1118 Crossref PubMed Scopus (105) Google Scholar The implication for training is of some concern as it has been shown that in most training programmes trainee exposure to the technique is largely inadequate. 3 Hawkins J.L. Gibbs C.P. General anesthesia for cesarean section: are we really prepared?. Int J Obstet Anesth. 1998; 7: 145-146 Abstract Full Text PDF PubMed Scopus (7) Google Scholar , 4 Johnson R.V. Lyons G.R. Wilson R.C. Robinson R.P.C. Training in obstetric general anaesthesia: a vanishing art?. Anaesthesia. 2000; 55: 179-183 Crossref PubMed Scopus (61) Google Scholar Since obstetric general anaesthesia is unlikely to disappear completely, Lipman et al. attempted to prescribe a cure for the problem of inexperienced practitioners administering obstetric general anaesthesia in developed countries. Although the practical and theoretical implications of diminishing expertise in obstetric general anaesthesia in the UK and other developed countries have been studied, 4 Johnson R.V. Lyons G.R. Wilson R.C. Robinson R.P.C. Training in obstetric general anaesthesia: a vanishing art?. Anaesthesia. 2000; 55: 179-183 Crossref PubMed Scopus (61) Google Scholar , 5 Brown G.W. Russell I.F. A survey of anesthesia for caesarean section. Int J Obstet Anesth. 1995; 4: 214-218 Abstract Full Text PDF PubMed Scopus (61) Google Scholar there has been no previous attempt to examine the impact this phenomenon may have on overseas trainees. We wished to examine the difference between training experience in obstetric anaesthesia in the UK and Ghana, a West African country.