Study Objectives: To determine how controversial the management of a n
umber of clinical scenarios that are labeled as controversial (eg, how
to induce anesthesia in the ''open eye-full stomach'' patient) are am
ong those practicing anesthesia. Design: Written survey. Setting: A na
tional anesthesiology review course. Subjects: 575 anesthesiologists a
ttending the review course. Interventions: Anesthesiologists were pres
ented 11 scenarios regarding some specific controversies in anesthetic
management; each scenario also described a suggested course of manage
ment. Two questions were asked for each scenario: ''Is this acceptable
practice?'' and ''Would you do this in your own practice?'' The scena
rios included using succinyl-choline for an ''open eye-full stomach''
patient, not evaluating preoperatively, the cardiac status of a patien
t after receiving adriamycin therapy, using triggering drugs after a n
egative muscle biopsy for malignant hyperthermia, ordering a pregnancy
test preoperatively for all females of child-bearing age, and seven o
thers. Measurements and Main Results: For each scenario, comparisons b
etween the number of respondents who felt a particular management was
acceptable practice and the number who would do this in their own prac
tice were made using chi-square analysis; p less than or equal to 0.05
was considered significant. 160 (27.8%) surveys were returned. In ten
scenarios, there was 70% or less agreement about whether a technique
was acceptable. In six scenarios, there was a significant difference b
etween the number of-respondents who felt a suggested management was a
cceptable practice and the number who would use it in their own practi
ce. Conclusions: This survey of anesthesiologists regarding these cont
roversial clinical scenarios showed that (a) most scenarios were in fa
ct controversial amongst those in practice, and (b) there were dispari
ties between whether a technique is believed to be acceptable practice
and whether it would be used in one's own practice. (C) 1997 by Elsev
ier Science Inc.