| Abstract | BACKGROUND: Rapid sequence induction (RSI) is the 'gold standard' technique for preventing aspiration of gastric contents during induction of anesthesia in unfasted patients. We conducted a survey to discover whether the conduct of RSI in children varies amongst anesthetists and if practice alters in relation to the time since training or degree of ongoing experience. METHODS: Six hundred and fifteen questionnaires were sent to anesthetists in the south-west of England. RESULTS: The response rate was 61%. Preoxygenation was utilized by 83% of anesthetists for infants whereas 94% preoxygenated schoolchildren, P < 0.001. Only 59% of respondents used cricoid pressure in infants, compared with 96% in schoolchildren, P < 0.001. Propofol was the induction agent of choice for all anesthetists, although thiopentone was used more in infants (35%) than schoolchildren (9%), P < 0.001. Suxamethonium was widely used in all children. All anesthetists intubated patients for pyloromyotomy, 50% using cricoid pressure. RSI was performed by 86% of anesthetists for appendicectomy, with consultants most likely to deviate from a standard RSI. Sixty percent of anesthetists intubated for manipulation of forearm, 72% performing an RSI, 53% intubated for scrotal exploration, but only 42% performed an RSI. CONCLUSIONS: Classical RSI is used for children by most anesthetists in south-west England. RSI is modified for infants especially by more recently trained consultants. Suxamethonium is used less by consultant anesthetists. Whilst RSI is performed for appendicectomy there is a large variation in techniques for anesthetizing children for MUA and scrotal exploration which is independent of the grade of anesthetist. |
| Authors | Judith Stedeford, Peter Stoddart
(Affiliation: Department of Anaesthesia, Bristol Children's Hospital, Bristol, UK. judithstedeford at hotmail.com)
|
| Journal | Paediatric anaesthesia
(Paediatr Anaesth)
Vol. 17
Issue 3
Pg. 235-42
(Mar 2007)
ISSN: 1155-5645 France |
| PMID | 17263738
(Publication Type: Journal Article)
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| Chemical References |
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| Topics |
- Anesthesia, General
(methods)
- Anesthesiology
(education)
- Chi-Square Distribution
- Child
- Cricoid Cartilage
- England
- Humans
- Infant
- Oxygen Inhalation Therapy
(utilization)
- Pediatrics
- Pressure
(adverse effects)
- Professional Practice
(statistics & numerical data)
- Questionnaires
- Respiratory Aspiration
(prevention & control)
- Succinylcholine
(therapeutic use)
- Surgical Procedures, Minor
- Time Factors
|
