BACKGROUND: There have been recent changes with regard to tools and concepts for respiratory management of children undergoing general anesthesia. OBJECTIVES: To determine the practice of pediatric anesthetists concerning: preoxygenation, breathing systems, ventilation modes, anesthetic agent and airway device, strategies for a general anaesthetic of less than 30 min using spontaneous respiration, and opinion about technical aspects of ventilation. METHODS: Online questionnaire sent by e-mail to all the anesthetists registered on the mailing list of the French-speaking Pediatric Anesthetists and Intensivists Association (ADARPEF). RESULTS: 232 questionnaires (46%) were returned. More than 25% of anesthetists surveyed declared that they do not perform preoxygenation before induction for children <15 years old, apart from neonates and clinical specific situations. When performed, <65% chose a FiO2 higher than 80%. Inhalational induction with sevoflurane is the preferred mode of induction set at 6% or 8%, respectively, 69% [62-75] vs 25% [18-31]. For induction, the circle system was the most popular circuit used in all ages. The accessory breathing system-Mapleson B type-was predominantly used for neonates (44% [37-54]). For maintenance of an anesthesia lasting <30 min in spontaneous breathing, the use of laryngeal mask increased with age, and the endotracheal tube was reserved for neonates (40% [33-48]). Pressure support ventilation was rarely used from the beginning of induction but was widely used for maintenance, whatever the age-group. Results differed according to the type of institution. CONCLUSION: Ventilation management depends on the age and institutions in terms of circuit, airway device or ventilation mode, and specific differences exist for neonates.
BACKGROUND: There have been recent changes with regard to tools and concepts for respiratory management of children undergoing general anesthesia. OBJECTIVES: To determine the practice of pediatric anesthetists concerning: preoxygenation, breathing systems, ventilation modes, anesthetic agent and airway device, strategies for a general anaesthetic of less than 30 min using spontaneous respiration, and opinion about technical aspects of ventilation. METHODS: Online questionnaire sent by e-mail to all the anesthetists registered on the mailing list of the French-speaking Pediatric Anesthetists and Intensivists Association (ADARPEF). RESULTS: 232 questionnaires (46%) were returned. More than 25% of anesthetists surveyed declared that they do not perform preoxygenation before induction for children <15 years old, apart from neonates and clinical specific situations. When performed, <65% chose a FiO2 higher than 80%. Inhalational induction with sevoflurane is the preferred mode of induction set at 6% or 8%, respectively, 69% [62-75] vs 25% [18-31]. For induction, the circle system was the most popular circuit used in all ages. The accessory breathing system-Mapleson B type-was predominantly used for neonates (44% [37-54]). For maintenance of an anesthesia lasting <30 min in spontaneous breathing, the use of laryngeal mask increased with age, and the endotracheal tube was reserved for neonates (40% [33-48]). Pressure support ventilation was rarely used from the beginning of induction but was widely used for maintenance, whatever the age-group. Results differed according to the type of institution. CONCLUSION: Ventilation management depends on the age and institutions in terms of circuit, airway device or ventilation mode, and specific differences exist for neonates.