Induction of Anaesthesia for Children. Should We Recommend the Needle of the Mask?

In his editorial Professor Davidson comments on the Ramgolam et al. report findings. He mentions the well acknowledged pharmacological reasons for the advantages of IV induction; faster passage of the child through the excitement phases of anaesthesia and the avoidance of a pungent irritating gas. He questions how well the study group represents other paediatric populations for example those children with fewer or no respiratory risk factors, who were given premedication and those that did not receive a laryngeal mask airway. Children deemed suitable for both methods of induction were chosen therefore excluding those with difficult veins or needle or mask phobia. Respiratory complications were the only outcomes measured and a number of those complications may be considered as minor and easy to manage.

Professor Davidson states that according to this study IV induction is somewhat safer in a child at risk of respiratory complications “all else being equal” however in patients outside of this population group many factors need to be considered when deciding on the most suitable induction technique.

Reviewed by: Dr Meredith Betts