Been doing paed anaesthesia for About 15 years. In elective simple surgerys haven't put an IV in first for at least 10 years.
My practice - sevoflurane induction, insert LMA or intubate when deep ( for lma if age < about 2 spray cords with lignocaine. If intubating then all get spray of lignocaine) . Then go and insert IV. Gas has had time to cause vasodilation so IV insertion much easier. This way you don't have to rely on unskilled people either holding a mask ( which most can't do and you have to keep watching to see they are doing ok) or inserting an IV and pranging the decent veins in the best spot.
15 years - complications rate zero. Need for suxamthonium during induction - zero. (So far)
Same question discussed on other forums - highly varied responses. Seems to be a very geographically varied practice. Some USA ones do same as me some the opposite.
My practice - sevoflurane induction, insert LMA or intubate when deep ( for lma if age < about 2 spray cords with lignocaine. If intubating then all get spray of lignocaine) . Then go and insert IV. Gas has had time to cause vasodilation so IV insertion much easier. This way you don't have to rely on unskilled people either holding a mask ( which most can't do and you have to keep watching to see they are doing ok) or inserting an IV and pranging the decent veins in the best spot.
15 years - complications rate zero. Need for suxamthonium during induction - zero. (So far)
Same question discussed on other forums - highly varied responses. Seems to be a very geographically varied practice. Some USA ones do same as me some the opposite.