DO NOT RESUSCITATE (DNR) ORDERS AND THE ANESTHESIOLOGIST - A SURVEY

Anesthesiologists were surveyed to determine their experience and opin ions regarding ''Do Not Resuscitate'' (DNR) orders in the perioperativ e period. Four hundred fifteen questionnaires were mailed and 193 (47% ) were returned. One hundred sixty-one (87%) of 186 respondents had be en requested to provide (and more than two-thirds had provided) monito red anesthesia care, regional anesthesia, or general anesthesia to a p atient with a DNR order. Almost two-thirds of the respondents assume D NR suspension in the perioperative period and only half discuss this a ssumption with the patient/guardian. Less than 50% of respondents woul d require DNR suspension for a palliative procedure contrasted with >6 0% for an elective procedure. After agreeing to a patient's decision t o retain their DNR status, >67%, >58%, <49%, and <33% would utilize po sitive pressure ventilation with a mask, vasoactive drugs, endotrachea l intubation, or defibrillation, respectively, in the event of a cardi opulmonary arrest in the perioperative period. These findings suggest much ambiguity regarding DNR orders in the perioperative period. Furth er discussion among physicians and patients is warranted.