An audit of sedation, analgesia and muscle relaxation in paediatric intensive care in the United Kingdom

Abstract

SummaryA questionnaire detailing four clinical cases (epiglottitis; head injury; aspiration pneumonitis and a neonate requiring postoperative pulmonary ventilation) was used to elicit the opinions of consultant paediatric anaesthetists in the UK regarding airway management, sedation level and drugs used in paediatric intensive care. Sixteen out of 18 replied. The preferred level of sedation varied and was deepest in head injury and lightest in epiglottitis. Airway management in epiglottitis most commonly involved a breathing system utilizing continuous positive airway pressure (CPAP). In the management of a head injury, a mixture of sedative, analgesic and muscle relaxant was preferred (15/16). Different combinations of drugs were preferred in managing the other three clinical cases. A majority of the participants (15/16) favoured intravenous infusions as the method of choice for drug delivery. Of the more recently introduced drugs, propofol was used occasionally or often in 11 units, compared with isoflurane and alfentanil in 1 and 4 units respectively. Complications from the long term use of many sedative drugs have been reported and constant vigilance is required to detect these effects.