Hostname: page-component-cd9895bd7-lnqnp Total loading time: 0 Render date: 2024-12-28T01:12:22.488Z Has data issue: false hasContentIssue false
  • English
  • Français

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
Get access

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

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Glosten B. Anesthesia for obstetrics. In: Miller RD, ed. Anesthesia, 5th edn. New York, USA: Churchill Livingstone, 2002: 2024–2068.
Benhamou D. French obstetric anaesthetists and acid aspiration prophylaxis. Eur J Anaesthesiol 1993; 10: 27–32.Google Scholar
Clergue F, Auroy Y, Pequignot F, Jougla E, Lienhart A, Laxenaire M. French survey of anesthesia in 1996. Anesthesiology 1999; 91: 1509–1520.Google Scholar
Soreide E, Holst-Larsen H, Steen PA. Acid aspiration syndrome prophylaxis in gynaecological and obstetric patients: a Norwegian survey. Acta Anaesthesiol Scand 1994; 38: 863–868.Google Scholar
Schneck H, Scheller M, Wagner R, von Hundelshausen B, Kochs E. Anaesthesia for cesarean section and acid aspiration prophylaxis: a German survey. Anesth Analg 1999; 88: 63–66.Google Scholar
Papiernik E, Zeitlin J, Milligan DWA, et al. Variations in the organization of obstetric and neonatal intensive care in Europe. Prenat Neonat Med 1999; 4 (Suppl 1): 73–87.Google Scholar
Warner MA, Warner ME, Weber JG. Clinical significance of pulmonary aspiration during the perioperative period. Anesthesiology 1993; 78: 56–62.Google Scholar
Ezri T, Szmuk P, Stein A, Konichezky S, Hagai T, Geva D. Peripartum general anaesthesia without tracheal intubation: incidence of aspiration pneumonia. Anaesthesia 2000; 55: 421–426.Google Scholar
Wright PM, Allen RW, Moore J, Donnelly JP. Gastric emptying during lumbar extradural analgesia in labour: effect of fentanyl supplementation. Br J Anaesth 1992; 68: 248–251.Google Scholar
Kelly MC, Carabine UA, Hill DA, Mirakhur RK. A comparison of the effect of intrathecal and extradural fentanyl on gastric emptying in laboring women. Anesth Analg 1997; 85: 834–838.Google Scholar
Michael S, Reilly CS. Policies for oral intake during labour: a survey of maternity units in England and Wales. Anaesthesia 1991; 46: 1071–1073.Google Scholar
Breen TW, McNeil T, Dierenfield L. Obstetric anesthesia practice in Canada. Can J Anaesth 2000; 47: 1230–1242.Google Scholar
Hawkins JL, Gibbs CP, Martin-Salvaj G, Orleans M, Beaty B. Oral intake policies on labor and delivery: a national survey. J Clin Anesth 1998; 10: 449–451.Google Scholar
Kubli M, Scrutton MJ, Seed PT, O'Sullivan G. An evaluation of isotonic ‘sport drinks’ during labor. Anesth Analg 2002; 94: 404–408Google Scholar
Scrutton MJ, Metcalfe GA, Lowy C, Seed PT, O'Sullivan G. Eating in labour, a randomised controlled trial assessing the risks and benefits. Anaesthesia 1999; 54: 329–334.Google Scholar
Stamer UM, Messerschmidt A, Wulf H. Anaesthesia for caesarian section: a German survey. Acta Anaesthesiol Scand 1998; 42: 678–684.Google Scholar
Kluger MT, Willemsen G. Anti-aspiration prophylaxis in New Zealand: a national survey. Anaesth Intensive Care 1998; 26: 70–77.Google Scholar
Thwaites AJ, Rice CP, Smith I. Rapid sequence induction: a questionnaire survey of its routine conduct and continued management during a failed intubation. Anaesthesia 1999; 54: 376–381.Google Scholar
Palot M, Chalé JJ, Colladon B, et al. Anesthésies et analgésies pratiquées dans les maternités françaises. Ann Fr Anesth Reanim 1998; 17: 210–219.Google Scholar
Riley ET, Papasin J. Epidural catheter function during labor predicts anesthetic efficacy for subsequent cesarean delivery. Int J Obstet Anesth 2002; 11: 81–84.Google Scholar
Deaths associated with anaesthesia. In: Report on Confidential Enquiries into Maternal Deaths in the United Kingdom, 1988–1990.London, UK: HMSO, 1994: 80–96.
Morris J, Cook TM. Rapid sequence induction: a national survey. Anaesthesia 2001; 56: 1090–1097.Google Scholar
Benhamou D. Cricoid pressure is unnecessary in obstetric general anaesthesia. Int J Obstet Anesth 1995; 4: 30–33.Google Scholar
Brimacombe JR, Alison MB. Cricoid pressure. Can J Anaesth 1997; 44: 414–425.Google Scholar
Maltby JR, Beriault MT. Science, pseudoscience and Sellick. Can J Anaesth 2002; 49: 443–447.Google Scholar
Laxenaire MC, Mertes PM. Anaphylaxis during anaesthesia. Results of a two-year survey in France. Br J Anaesth 2001; 87: 549–558.Google Scholar