{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,28]],"date-time":"2026-06-28T03:47:32Z","timestamp":1782618452156,"version":"3.54.5"},"reference-count":13,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2015,2,23]],"date-time":"2015-02-23T00:00:00Z","timestamp":1424649600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Anesthesia"],"published-print":{"date-parts":[[2015,7]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Infants with pyloric stenosis are considered to be at high risk of aspiration on induction of anesthesia. Traditionally, texts have recommended classic rapid sequence induction (<jats:styled-content style=\"fixed-case\">RSI<\/jats:styled-content>) or awake intubation (<jats:styled-content style=\"fixed-case\">AI<\/jats:styled-content>). <jats:styled-content style=\"fixed-case\">AI<\/jats:styled-content> has generally fallen out of favor, while the components of <jats:styled-content style=\"fixed-case\">RSI<\/jats:styled-content> have become increasingly controversial. Infants are at high risk of hypoxemia if ventilation is not maintained while waiting for neuromuscular blockade to establish. The efficacy of cricoid pressure (<jats:styled-content style=\"fixed-case\">CP<\/jats:styled-content>) to prevent aspiration has not been proven. It can impair visualization of the glottis and make intubation difficult. It is debatable whether any <jats:styled-content style=\"fixed-case\">RSI<\/jats:styled-content> technique is needed for pyloromyotomy. A recent review of 235 infants reported no aspiration events. These children were anesthetized with a variety of techniques, including <jats:styled-content style=\"fixed-case\">RSI<\/jats:styled-content>, gas induction, and <jats:styled-content style=\"fixed-case\">AI<\/jats:styled-content>. In our institution, we teach a gaseous induction. The nasogastric tube is used to empty the stomach and anesthesia is induced with sevoflurane. A nondepolarizing muscle relaxant is administered and ventilation maintained until neuromuscular blockade is established and intubating conditions are optimal. We report our experience of this technique.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>A retrospective medical notes review of all patients undergoing pyloromyotomy between 2005 and 2012.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 269 patients (84.4% male, mean weight 3.74\u00a0kg\u00a0\u00b1\u00a00.74). Two hundred and fifty\u2010two (93.7%) received gas inductions and 17 (6.3%) intravenous (<jats:styled-content style=\"fixed-case\">IV<\/jats:styled-content>) inductions. Two children received an <jats:styled-content style=\"fixed-case\">RSI<\/jats:styled-content>. No patient\u2010specific factors were identified to explain operator choice in those receiving <jats:styled-content style=\"fixed-case\">IV<\/jats:styled-content> inductions. There were no recorded aspiration events.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Gas induction can be considered for children undergoing pyloromyotomy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pan.12633","type":"journal-article","created":{"date-parts":[[2015,2,23]],"date-time":"2015-02-23T07:39:08Z","timestamp":1424677148000},"page":"677-680","source":"Crossref","is-referenced-by-count":29,"title":["Gas induction for pyloromyotomy"],"prefix":"10.1111","volume":"25","author":[{"given":"Gemma E.","family":"Scrimgeour","sequence":"first","affiliation":[{"name":"Shackleton Department of Anaesthesia University Hospital Southampton Southampton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas W.F.","family":"Leather","sequence":"additional","affiliation":[{"name":"Shackleton Department of Anaesthesia University Hospital Southampton Southampton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel S.","family":"Perry","sequence":"additional","affiliation":[{"name":"Shackleton Department of Anaesthesia University Hospital Southampton Southampton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John V.","family":"Pappachan","sequence":"additional","affiliation":[{"name":"Shackleton Department of Anaesthesia University Hospital Southampton Southampton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J.","family":"Baldock","sequence":"additional","affiliation":[{"name":"Shackleton Department of Anaesthesia University Hospital Southampton Southampton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,2,23]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF03008206"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.sempedsurg.2006.10.004"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000539-199805000-00006"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1460-9592.2001.00535.x"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0b013e3181d5ae47"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aep337"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9592.2010.03287.x"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-6576.2009.02060.x"},{"key":"e_1_2_10_10_1","first-page":"309","article-title":"Induction and airway management for pyloromyotomy","volume":"4","author":"Considine AA","year":"2011","journal-title":"J Anesthe Clinic Res"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/73.4.559"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.140.12.1191"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-199901000-00011"},{"key":"e_1_2_10_14_1","unstructured":"The Royal College of Anaesthetists.Report and findings of the 4th National Audit Project of The Royal College of Anaesthetists. Available at:http:\/\/www.rcoa.ac.uk\/system\/files\/CSQ-NAP4-Full.pdf. Accessed 21 August 2014."}],"container-title":["Pediatric Anesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fpan.12633","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pan.12633","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,1]],"date-time":"2023-10-01T13:08:26Z","timestamp":1696165706000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/pan.12633"}},"subtitle":[],"editor":[{"given":"Adrian","family":"Bosenberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2015,2,23]]},"references-count":13,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2015,7]]}},"alternative-id":["10.1111\/pan.12633"],"URL":"https:\/\/doi.org\/10.1111\/pan.12633","archive":["Portico"],"relation":{},"ISSN":["1155-5645","1460-9592"],"issn-type":[{"value":"1155-5645","type":"print"},{"value":"1460-9592","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,2,23]]}}}