Anesthetic management of preschool children with penetrating eye injuries: postal survey of pediatric anesthetists and review of the available evidence

Summary Background : Pediatric anesthetists were surveyed regarding their anesthesia management of a screaming child with a penetrating eye injury. The results are reviewed in relation to the available evidence in the literature. Methods : A postal survey was sent to all the members of the APA living in the UK. Seven clinical questions were asked regarding the management of penetrating eye injury and two questions regarding seniority and the number of cases seen. Results : Of the 318 questionnaires sent out 238 were evaluated. Of the responders indicating the number of cases seen, 21.2% had never seen a single case, 55.1% had seen <5, 17.8% had seen 5–10, and 5.9% had seen >10 cases. Suxamethonium was used more often by respondents who had handled more cases; 42.9% of those doing >10 compared with 10% of those doing less than five cases. Senior anesthetists preferred the use of techniques without relaxants and to extubate children under deep anesthesia. Conclusions : Few people have extensive experience managing a penetrating eye injury in a child. A variety of anesthesia techniques are used for induction with anesthetists avoiding suxamethonium, despite there being little evidence in the literature that the use of suxamethonium is harmful to the open globe.