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Anaesthesia for day case surgery: a survey of paediatric clinical practice in the UK

Published online by Cambridge University Press:  02 June 2005

K. Payne
Affiliation:
University of Manchester, School of Pharmacy & Pharmaceutical Sciences, Manchester, UK
E. W. Moore
Affiliation:
Wirral Hospital NHS Trust, Department of Anaesthesia, Wirral, UK
R. A. Elliott
Affiliation:
University of Manchester, School of Pharmacy & Pharmaceutical Sciences, Manchester, UK
J. K. Moore
Affiliation:
Wirral Hospital NHS Trust, Department of Anaesthesia, Wirral, UK
G. A. McHugh
Affiliation:
University of Manchester, School of Nursing, Midwifery & Health Visiting, Manchester, UK
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Extract

Summary

Background and objective: In October 2000, we conducted a national postal survey of day case consultant anaesthetists in the UK to explore the range and variation in practice of anaesthetizing a patient for day case surgery (paediatrics, urology and orthopaedics). This paper reports the findings of this national survey of paediatric day case anaesthetic practice carried out as part of a major two-centre randomized controlled trial designed to investigate the costs and outcome of several anaesthetic techniques during day care surgery in paediatric and adult patients (cost-effectiveness study of anaesthesia in day case surgery).

Methods: The survey used a structured postal questionnaire and collected data on the duration of surgical procedure; the use of premedication; the anaesthetic agents used for induction and maintenance; the fresh gas flow rates used for general anaesthesia; the use of antiemetics; and the administration of local anaesthesia and analgesia.

Results: The overall response rate for the survey was 74 and 63% for the paediatric section of the survey. Respondents indicated that 19% used premedication, 63% used propofol for induction, 54% used isoflurane for maintenance, 24% used prophylactic antiemetics and 85% used a laryngeal mask. The findings of this national survey are discussed and compared with published evidence.

Conclusions: This survey identifies the variation in clinical practice in paediatric day surgery anaesthesia in the UK.

Type
Original Article
Copyright
© 2003 European Society of Anaesthesiology

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References

Bartamian M, Meyer DR. Site of service, anesthesia and operative practice patterns for oculoplastic and orbital surgeries. Ophthalmology 1996; 103: 16281633.Google Scholar
Guidelines for Day Case Surgery. London, UK: Royal College of Surgeons of England, 1992.
Brennan LJ. Modern day case anaesthesia for children. Br J Anaesth 1999; 83: 91103.Google Scholar
Gurkan Y, Kilickan L, Toker K. Propofol–nitrous oxide versus sevoflurane–nitrous oxide for strabismus surgery in children. Paediatr Anaesth 1999; 9: 495499.Google Scholar
Payne K, Moore EW, Elliott RA, Pollard BJ, McHugh GA. Anaesthesia for day case surgery: a survey of adult clinical practice in the United Kingdom. Eur J Anaesthesiol 2003; 20: 311324.Google Scholar
Kotiniemi LH, Ryhanen PT. Behavioural changes and children's memories after intravenous, inhalation and rectal induction of anaesthesia. Anaesthesia 1996; 6: 201207.Google Scholar
Williams PJ, Bailey PM. Comparison of the reinforced laryngeal mask airway and tracheal intubation for adenotonsillectomy. Br J Anaesth 1993; 70: 3033.Google Scholar
Runcie CJ, Mackenzie SJ, Arthur DS, Morton NS. Comparison of recovery from anaesthesia induced in children with either propofol or thiopentone. Br J Anaesth 1993; 70: 192195.Google Scholar
Walker SM, Haugen RD, Richards A. A comparison of sevoflurane with halothane for paediatric day case surgery. Anaesth Intensive Care 1997; 25: 643649.Google Scholar
Piat V, Dubois MC, Johanet S, Murat I. Induction and recovery characteristics and hemodynamic responses to sevoflurane and halothane in children. Anesth Analg 1994; 79: 840844.Google Scholar
Lerman J, Davis PJ, Welborn LG, et al. Induction, recovery, and safety characteristics of sevoflurane in children undergoing ambulatory surgery. Anesthesiology 1996; 84: 13321340.Google Scholar
Viitanen H, Tarkkila P, Mennander S, Viitanen M, Annila P. Sevoflurane-maintained anesthesia induced with propofol or sevoflurane in small children: induction and recovery characteristics. Can J Anaesth 1999; 46: 2128.Google Scholar
Naito Y, Tamai S, Shingu K, Fujimori R, Mori K. Comparison between sevoflurane and halothane for paediatric ambulatory anaesthesia. Br J Anaesth 1991; 67: 387389.Google Scholar
Greenspun J, Hannallah RS, Welborn LG, Norden JM. Comparison of sevoflurane and halothane anesthesia in children undergoing outpatient ear, nose and throat surgery. J Clin Anesth 1995; 7: 398402.Google Scholar
Johannesson GP, Floren M, Lindahl SGE. Sevoflurane for ENT-surgery in children a comparison with halothane. Acta Anaesthesiol Scand 1995; 39: 546550.Google Scholar
Ariffin SA, Whyte JA, Malins AF, Cooper GM. Comparison of induction and recovery between sevoflurane and halothane supplementation of anaesthesia in children undergoing outpatient dental extractions. Br J Anaesth 1997; 78: 157159.Google Scholar
Meretoja OA, Taivainen T, Raiha L, Korpela R, Wirtavuori K. Sevoflurane–nitrous oxide or halothane– nitrous oxide for paediatric bronchoscopy and gastroscopy. Br J Anaesth 1996; 76: 767771.Google Scholar
Uezono S, Goto T, Terui K, et al. Emergence agitation after sevoflurane versus propofol in pediatric patients. Anesth Analg 2000; 91: 563566.Google Scholar
Short JA, Barr CA, Palmer CD, et al. Use of diclofenac in children with asthma. Anaesthesia 2000; 55: 334337.Google Scholar
Guidelines for the Use of NSAIDs in the Perioperative Period. London, UK: Royal College of Anaesthetists, 1998.
Baines D. Postoperative nausea and vomiting in children. Paediatr Anaesth 1996; 6: 714.Google Scholar
Fujii Y, Toyooka H, Tanaka H. Prophylactic antiemetic therapy with granisetron, doperidol and metoclopramide in female patients undergoing middle ear surgery. Anaesthesia 1998; 53: 11651168.Google Scholar
Paxton D, Taylor RH, Gallagher TM. Postoperative emesis following otoplasty in children. Anaesthesia 1995; 50: 10831085.Google Scholar
Rose JB, Watcha MF. Postoperative nausea and vomiting in paediatric patients. Br J Anaesth 1999; 83: 104117.Google Scholar