Sedation versus General Anesthesia for Intubation: Reply

We read with interest Dr. Feldman’s correspondence¹  regarding our study comparing sedation to general anesthesia in children enrolled in the Pediatric Difficult Intubation Registry.²  He noted correctly that 27% of the sedated cohort required conversion to general anesthesia and suggested that having a separate clinician administer the sedation may improve the success rate of tracheal intubation using sedation. Dr. Feldman highlights practice guidelines for non-anesthesiologists to support this idea. Dr. Feldman’s suggestion is an interesting one that makes intuitive sense. Although we suspect that having a clinician dedicated solely to managing the sedation would improve the success rate, we want to clarify that all the tracheal intubations in our study were managed by anesthesiologists, who routinely manage the airway and the anesthetic concurrently. We, however, agree that having a separate clinician administering sedition might improve its efficacy and allow the airway managers to focus solely on tracheal intubation....