Tourtier J P, Compain M, Petitjeans F, Villevieille T, Chevalier J F, Mercier F J, Benhamou D
Hôpital Antoine Béclère, Department of Anaesthesia and Intensive Care, Clamart, France.
Eur J Anaesthesiol. 2004 Feb;21(2):89-94. doi: 10.1017/s0265021504002029.
To survey French anaesthetic practice regarding acid aspiration prophylaxis and compare it with an earlier survey.
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.
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 479 (1998) (P < 0.05).
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.
调查法国产科麻醉中预防误吸的实践情况，并与早期调查结果进行比较。
向法国所有800个产科单位发送了一份保密问卷，以评估三个主要主题：（a）用于药物预防的药物；（b）分娩和剖宫产的区域麻醉；（c）全身麻醉和气管插管所采用的技术。
202个单位做出了回应。1998年，78%做出回应的单位对分娩妇女常规使用药物预防（1988年为63%，P<0.05）。剖宫产术前使用抗酸药物的比例从1988年的75%增至1998年的97%（P<0.05）。做出回应的单位中，不到2%的单位在剖宫产时采用全身麻醉（1988年为21%，P<0.05）。相比之下，1988年至1998年间，器械助产时气管插管的使用情况（53%对50%）或人工剥离胎盘时气管插管的使用情况（15%对16%）变化不大。在这10年期间，环状软骨压迫法的使用显著增加（50%对88%，P<0.05），80%做出回应的单位对该技术描述正确（1988年为50%，P<0.05）。同样，琥珀酰胆碱的使用从1988年的25%显著增至1998年的47%（P<0.05）。
法国产科在预防误吸方面的整体实践有显著改善。然而，并非每位患者都采用了完整的预防策略，这凸显了继续医学教育的必要性。
