Circulation 60,475 • Volume 13, No. 1 • Spring 1998

Pediatric Induction Practices Surveyed

Tracheal intubation with inhalational agent without muscle relaxants (IAWMR) has been an accepted technique when used for the management of difficult pediatric airways. Spontaneous ventilation during induction has been proposed to decrease the likelihood of complete airway obstruction. Intubation with IAWMR has also been used for healthy pediatric patients with normal airways. Some physicians have expressed concern that this technique may present risks (e.g. laryngospasm, airway trauma, cardiovascular depression) that outweigh the benefits. George Politis, M.D., Robert Morell, M.D., and Joseph Tobin, M.D., investigators at Wake Forest University School of Medicine, are surveying members of the Society for Pediatric Anesthesia (SPA) to determine the frequency with which IAWMR is used for healthy routine pediatric patients. Anesthesiologists’ reasons for choosing this technique and their attitudes regarding its safety are also being examined.

Approximately one third of American SPA members received surveys, and 70% responded. Preliminary data indicate that nearly 40% of respondents routinely intubate healthy infants and children with IAWMR. There is also a positive association between non-academic practice and utilization of this technique. The investigators emphasized that this survey includes only SPA members and may not reflect the practice patterns of anesthesiologists with occasional or rare pediatric patients.