Nationwide characterization of labor neuraxial analgesia provision in Japan using a publicly accessible database.

Authors

Daisuke Sakamaki, Kazutoshi Onitsuka, Yusuke Mazda

Published in

Journal of anesthesia. Oct 25, 2025. Epub Oct 25, 2025.

Abstract

In Japan, labor neuraxial analgesia (LNA) is frequently administered by obstetricians rather than board-certified anesthesiologists, particularly in smaller facilities. Although awareness of maternal safety has increased in recent years, the extent of anesthesiologist involvement in obstetric anesthesia remains unclear.
This nationwide cross-sectional study analyzed data from Birth-Navi, a public registry of childbirth facilities maintained by Ministry of Health, Labour and Welfare of Japan. As of August 2024, facilities offering LNA were categorized into two groups: those listing a board-certified anesthesiologist (Group A) and an obstetrician-gynecologist (Group O) as a responsible physician. Institutional characteristics and analgesia practices were compared between groups using chi-square tests.
Among 2063 registered facilities, 837 (40.6%) provided LNA, of which 771 met the inclusion criteria. Only 27.2% facilities listed a board-certified anesthesiologist as the responsible physician. Group A facilities were more likely to be hospitals (86.8% vs. 30.4%, p < 0.001) and more likely to utilize combined spinal-epidural techniques (23.7% vs. 14.0%, p = 0.002). However, 24 h analgesia availability was significantly lower in Group A than in Group O (25.9% vs. 47.1%, p < 0.05). Notably, only 284 facilities (13.8%) provided round-the-clock analgesia upon maternal request.
It is important to note that anesthesiologist-led LNA remains limited in Japan. While associated with more advanced techniques, 24 h availability is uncommon. To improve both access and safety, system-level strategies-such as redistribution of personnel and the implementation of collaborative tele-anesthesia networks-should be considered.

PMID:
41139167
Bibliographic data and abstract were imported from PubMed on 26 Oct 2025.

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