Thwaites A J, Rice C P, Smith I
Keele University/North Staffordshire Hospitals, Stoke-on-Trent, Staffordshire, UK.
Anaesthesia. 1999 Apr;54(4):376-81. doi: 10.1046/j.1365-2044.1999.00738.x.
Two hundred and ten obstetric anaesthetists completed a questionnaire assessing how they would perform a rapid sequence induction of anaesthesia for a Caesarean section and their continued management during a failed tracheal intubation. The survey revealed considerable variation in the timing and application of cricoid pressure, the choice and dose of drugs used and the timing of their administration. The management of a difficult intubation also varied. This variability was independent of both grade of anaesthetist and frequency of practice. There appear to be at least two distinct techniques in current practice, characterised by 'fast' or 'slow' rapid sequence induction. Rapid sequence induction is clearly not a standard technique and debate is necessary to clarify the risks and benefits of its components. In particular, the rapidity of the technique and the application of cricoid pressure may contribute to the increased incidence of difficult tracheal intubation in obstetric anaesthesia.
210名产科麻醉医生完成了一份调查问卷，该问卷评估了他们在剖宫产手术中如何进行快速顺序诱导麻醉以及在气管插管失败时的后续处理。调查显示，在环状软骨压迫的时机和应用、所用药物的选择和剂量以及给药时间方面存在很大差异。困难插管的处理方式也各不相同。这种变异性与麻醉医生的级别和实践频率均无关。目前的实践中似乎至少存在两种不同的技术，其特点是“快速”或“缓慢”快速顺序诱导。快速顺序诱导显然不是一种标准技术，有必要进行讨论以阐明其各个组成部分的风险和益处。特别是，该技术的快速性和环状软骨压迫的应用可能导致产科麻醉中困难气管插管的发生率增加。
