The survey, printed in the two sides of one letter-size sheet of paper, was developed and validated by a group of four board-certified Mexican anesthesiologists and two epidemiologists. It was attached to the documents given to the 989 persons inscribed to the Annual Course of the Colegio Mexicano de Anestesiología (formerly the Sociedad Mexicana de Anestesiología) performed in July, last year. Conference participants were encouraged to fill out and return the survey at the end of each conference day during the three days of the course. Of 989, 282 (28.5%) surveys were returned. Data from returned surveys was captured in a pre-designed Microsoft 97®Excel form and reported as the number of respondents and proportions. In some cases, numbers could vary according to persons answering any specific question.
The survey included the following four sections:
Section 1: General information.
1) Your current maximal specialty training is: anesthesiologist, anesthesiologist with subspecialty training, or anesthesiology resident.
2) Have you been practicing anesthesia for < 5, 5 to 10, or >10 years?
3) Have you been working at a public, private or both types of health services?
4) Are your anesthetic procedures performed in pediatric, adults, or mixed patients? If mixed patients was selected, then the proportion representing the pediatric patients was asked (<25, 25 to 50, 50 to 75 or >75%).
5) Are your anesthetic procedures performed on ambulatory, hospitalized or mixed patients? If a mixed setting was selected, then the proportion representing the ambulatory patients was asked (<25, 25 to 50, 50 to 75 or >75%).
Section 2: Basic questions on neuromuscular relaxation. Questions were elaborated with information obtained from different sources including textbooks [1, 12], printed documents obtained by subscription [13], guidelines [14] and web-sites [15]. All sources were available in Spanish language, at any medical library or freely accessed on the Internet.
6) Neuromuscular relaxants are classified according to: chemical structure, duration of action, action at the neuromuscular junction or you do not know.
7) The pharmacodynamic parameter of T25 represents: the time to loss the muscular tone, the time to maximal block, the clinical duration of the neuromuscular block, or you do not know.
8) Which of the following methods is considered as the gold standard for neuromuscular monitoring system? Electromyography, mechanomyography, electrophysiology, acceloromyography, or you do not know.
9) Which is the recommended dose of rocuronium for any patient undergoing an elective surgery? 150, 300, 600, 900, 1200 μg · kg-1 or you do not know.
10) Which produces less histamine liberation: vecuronium, rocuronium, vecuronium and rocuronium in a similar potency, or you do not know?
Section 3: Clinical practice
11) In which percentage of daily surgical procedures do you utilize a neuromuscular blocking drug? In <25, 25 to 50, 50 to 75, or >75%.
12) Do you routinely use any neuromuscular monitoring system and if so, which method do you use?
13) Vecuronium is available for reconstitution in two forms, as an ampoule for single sampling or as a multiple sampling vial. Which one do you prefer?
14) Do you prefer rocuronium as: an ampoule for single sampling, a vial for multiple sampling, any of these two forms, or as a different form?
15) Do you know the unitary cost of vecuronium? Yes or no.
16) Do you know the unitary cost of rocuronium? Yes or no.
17) Have you ever used rocuronium? Yes or no.
SECTION 4: Preferences among rocuronium, vecuronium or other neuromuscular relaxant.
Question: Which neuromuscular blocking drug do you prefer: rocuronium, vecuronium or other NMB agent...?
18) For an ambulatory patient undergoing a surgical procedure of one to two hours of duration.
19) For a low surgical risk (ASA 1) male patient, aged 19 yr., undergoing a septorhinoplasty.
20) For a female patient, 32 years old, suffering appendicitis and undergoing general anesthesia with tracheal intubation for an emergency surgery with full stomach.
21) For a low surgical risk (ASA 1) pediatric patient, 6 yr. old, undergoing a planned surgical repair of a bilateral inguinal hernia of 1.5 h of duration.
SECTION 5: Behaviors in relation to the drug excess after obtaining one dose of either vecuronium or rocuronium.
22) What do you do with the excess of the neuromuscular blocking agent after one dose is obtained, to conserve it in the same syringe, to maintain it in the vial or ampoule, to conserve it in several syringes, or to discharge it?
23) If you conserve unused drug, do you refrigerate it? Yes or no.