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Acid aspiration prophylaxis in obstetrics in France: a comparative survey of 1998 vs. 1988 French practice

Published online by Cambridge University Press:  23 December 2004

J.-P. Tourtier ,
M. Compain ,
F. Petitjeans ,
T. Villevieille ,
J.-F. Chevalier ,
F. J. Mercier  and
D. Benhamou
J.-P. Tourtier
Affiliation:
Hôpital Antoine Béclère, Department of Anaesthesia and Intensive Care, Clamart, France
M. Compain
Affiliation:
Hôpital Antoine Béclère, Department of Anaesthesia and Intensive Care, Clamart, France
F. Petitjeans
Affiliation:
Hôpital Antoine Béclère, Department of Anaesthesia and Intensive Care, Clamart, France
T. Villevieille
Affiliation:
Hôpital Antoine Béclère, Department of Anaesthesia and Intensive Care, Clamart, France
J.-F. Chevalier
Affiliation:
Hôpital Antoine Béclère, Department of Anaesthesia and Intensive Care, Clamart, France
F. J. Mercier
Affiliation:
Hôpital Antoine Béclère, Department of Anaesthesia and Intensive Care, Clamart, France
D. Benhamou
Affiliation:
Hôpital Antoine Béclère, Department of Anaesthesia and Intensive Care, Clamart, France
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Abstract

Summary

Background and objective: To survey French anaesthetic practice regarding acid aspiration prophylaxis and compare it with an earlier survey.

Methods: A confidential questionnaire was sent to all 800 maternity units in France to assess three major topics: (a) drugs used for pharmacological prophylaxis; (b) regional anaesthesia for labour and Caesarean section and (c) techniques used for general anaesthesia and endotracheal intubation.

Results: Two-hundred-and-two units responded. Pharmacological prophylaxis was regularly used for labouring women in 78% of the responding units in 1998 (compared with 63% in 1988, P < 0.05). Antacid drug use before Caesarean section had increased from 75% in 1988 to 97% in 1998 (P < 0.05). General anaesthesia was used for Caesarean section by less than 2% of responding units (vs. 21% in 1988, P < 0.05). In contrast, there was little change in the use of endotracheal intubation for instrumental delivery (53% vs. 50%) or manual removal of the placenta (15% vs. 16%) between 1988 and 1998. The use of cricoid pressure increased significantly during the 10 yr period (50% vs. 88%, P < 0.05) and the technique was correctly described by 80% of the responding units (vs. 50%, P < 0.05). Similarly, the use of succinylcholine increased significantly from 25% (1988) to 47% (1998) (P < 0.05).

Conclusions: There was a significant overall improvement of French practice regarding acid aspiration prophylaxis in obstetrics. However, the complete prophylaxis strategy is still not used in every patient emphasizing the need for continuing medical education.

Keywords

ANAESTHESIA CONDUCTION, spinal, epiduralANTI-ULCER AGENTS, antacidsNEUROMUSCULAR DEPOLARIZING AGENTS, succinylcholineOBSTETRIC SURGICAL PROCEDURES, delivery, obstetric, Caesarean sectionRESPIRATION, respiratory mechanics, aspiration, gastrointestinal agents
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 21 , Issue 2 , February 2004 , pp. 89 - 94
Copyright
2004 European Society of Anaesthesiology

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