Hostname: page-component-78c5997874-t5tsf Total loading time: 0 Render date: 2024-11-10T13:24:46.638Z Has data issue: false hasContentIssue false

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
Get access

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

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

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