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A survey of practice of tracheal intubation without muscle relaxant in paediatric patients
Author(s) -
SIMON LIONEL,
BOUCEBCI KARIM J,
ORLIAGUET GILLES,
AUBINEAU JEANVINCENT,
DEVYS JEANMICHEL,
DUBOUSSET ANNEMARIE
Publication year - 2002
Publication title -
pediatric anesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.704
H-Index - 82
eISSN - 1460-9592
pISSN - 1155-5645
DOI - 10.1046/j.1460-9592.2002.00727.x
Subject(s) - medicine , sevoflurane , tracheal intubation , intubation , propofol , anesthesia , muscle relaxant
Background : Because of the renewed interest in intubation in children without relaxants, over a period of 1 month, the anaesthesiologists of five paediatric universitary teaching hospitals were asked to complete a questionnaire each time they performed a tracheal intubation without muscle relaxant. Methods : Intubating conditions were assessed with five items. Each item was graded on a four‐point scale. Intubating conditions were judged acceptable when all items scored 2 or less. Episodes of oxygen desaturation and failed intubations were noted. Data are expressed as mean ± SD (extremes). Results : Five hundred and two questionnaires were completed during the study period. Children were aged 61 ± 50 (1–180) months old. Induction of anaesthesia was performed with sevoflurane for 62.6% of the children (endtidal concentration 5.9 ± 1.5%) and propofol for 28.9% (dose 5.8 ± 4.2 mg·kg –1 ). Opioids were associated with these hypnotics in 53.2% of the children. Tracheal intubation was successful in 87.1% of the children. Sevoflurane produced better intubating conditions than propofol. Sevoflurane requirements for tracheal intubation may be higher in infants aged less than 6 months old than in older children. A severe decrease in SpO 2 (≤ 90%) was observed in 15.9% of the infants aged less than 1 year old and in 1.7% of the children, respectively ( P < 0.0001). Conclusions : Sevoflurane is the most commonly used agent for tracheal intubation without relaxants with higher doses being required in infants aged less than 6 months. Propofol, even with opioids, was not so successful.