Duration of Apnea in Anesthetized Infants and Children Required for Desaturation of Hemoglobin to 95%

Kinouchi, Keiko; Tanigami, Hironobu; Tashiro, Chikara; Nishimura, Masaharu; Fukumitsu, K; Takauchi, Yuji

doi:10.1097/00000542-199212000-00010

Cited by 84 publications

(36 citation statements)

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“…Studies have shown that up to 70% of the pediatric patients have a history of URI within six weeks prior to surgery. [2][3][4][5] There have been reports of increased perioperative morbidity in children presenting to surgery with an actual or recent (\ six weeks) URI. 2,4 An increased number of episodes of laryngospasm, desaturation, increased oral secretion, and coughing has been observed at induction, emergence, and throughout the postoperative phase period.…”

Section: Résumémentioning

confidence: 99%

Topical lidocaine reduces the risk of perioperative airway complications in children with upper respiratory tract infections

Schebesta

Güloglu

Chiari

et al. 2010

Can J Anesth/J Can Anesth

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Purpose To determine the effect of topically applied lidocaine on perioperative airway complications when using a laryngeal mask airway device (LMAD) in children either with or without a history of recent or ongoing upper respiratory tract infection (URI). Methods In a randomized controlled double-blind trial, 34 children with a history of recent or ongoing URI and 32 non-URI children-all of whom were younger than age ten and scheduled to undergo minor surgical procedureswere randomly assigned to either a lidocaine or a placebo group. In the lidocaine group, an LMAD was lubricated with lidocaine gel before insertion, and a clear lubricating gel was used in the placebo group. The following data were recorded after standardized anesthesia induction and airway management: postoperative complications, such as coughing, desaturation, laryngospasm, and increased oral secretions, as well as length of stay in the postanesthetic recovery unit. Results Children with URI had a lower overall perioperative complication rate if they received a lidocaine gel (35%) rather than placebo (94%) (P \ 0.01). Also, the incidence of postoperative coughing was less (12% vs 53%; P = 0.03). In non-URI patients, lidocaine did not significantly reduce the rate of airway complications compared with placebo (17% vs 24%, respectively).Conclusion Lubrication of the LMAD with lidocaine gel reduces the incidence of airway complications in children with an upper respiratory tract infection. RésuméObjectif De´terminer l'effet d'une application topique de lidocaı¨ne sur les complications pe´riope´ratoires au niveau des voies ae´riennes lors de l'utilisation d'un masque larynge( LMAD) chez des enfants avec ou sans infection re´cente ou actuelle des voies respiratoires supe´rieures. Méthode Dans une e´tude randomise´e contrôle´e à double insu, 34 enfants avec une infection re´cente ou actuelle des voies respiratoires supe´rieures et 32 enfants sans infection, tous plus jeunes que 10 ans et devant subir des interventions chirurgicales mineures, ont e´te´randomise´s a`recevoir soit de la lidocaı¨ne, soit un placebo. Dans le groupe lidocaı¨ne, un LMAD a e´te´lubrifie´a`l'aide de lidocaı¨ne en gel avant l'insertion, et un gel lubrifiant clair a e´te´utilise´dans le groupe placebo. Les donne´es suivantes ont e´te´enregistre´es apre`s une induction de l'anesthe´sie et une prise en charge standard des voies ae´riennes: les complications postope´ratoires, telles que toux, de´saturation, laryngospasme et se´cre´tions orales accrues, ainsi que la dure´e de se´jour dans la salle de re´veil post-anesthe´sique. Résultats Les enfants souffrant d'infection des voies respiratoires supe´rieures ont montre´un taux global de complications pe´riope´ratoires plus bas lorsqu'ils ont reçu de la lidocaı¨ne en gel (35 %) plutôt que le placebo (94 %) (P\0,01). De plus, l'incidence de toux postope´ratoire e´tait moindre (12 % vs 53 %; P = 0,03). Chez les patients ne souffrant pas d'infection des voies respiratoires supe´rieures, la lidocaı¨ne n'a pas re´duit le taux de ...

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Section: Résumémentioning

confidence: 99%

Topical lidocaine reduces the risk of perioperative airway complications in children with upper respiratory tract infections

Schebesta

Güloglu

Chiari

et al. 2010

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

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“…[5][6][7][8] This is a common challenge in pediatric anesthesia, since previous studies have shown a 30-40% prevalence of recent URI in an unselected population presenting for elective surgery. 6,9 Elective surgery may be cancelled because of recent URI, although individual practice varies widely. 10 The circumvention of complications that cancellation achieves may not justify the inconvenience of postponing a procedure, 11 especially since another URI may develop while awaiting rescheduled surgery -children have an average of six URI per year.…”

mentioning

confidence: 99%

Bronchodilator premedication does not decrease respiratory adverse events in pediatric general anesthesia

Elwood

Morris

Martin

et al. 2003

Can J Anesth/J Can Anesth

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P Pu ur rp po os se e: : Upper respiratory infections (URI) presage perioperative respiratory complications, but thresholds to cancel surgery vary widely. We hypothesized that autonomically-mediated complications seen during emergence from anesthesia would be predicted by capnometry and reduced with preoperative bronchodilator administration.M Me et th ho od ds s: : Afebrile outpatient tertiary-care children (age two months to 18 yr, n = 109) without lung disease or findings, having non-cavitary, non-airway surgery for under three hours, were randomized to bronchodilator premedication vs placebo and had preoperative capnometry. After halothane via mask, laryngeal mask airway, or endotracheal tube, and regional anesthesia as appropriate, patients recovered breathing room air while cough, wheeze, stridor, laryngospasm, and cumulative desaturations were recorded for 15 min.

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“…As crianças que apresentam rinorréia desenvolvem curtos períodos de apnéia durante a anestesia, antes mesmo que haja diminuição da saturação da hemoglobina pelo oxigênio (SpO 2 ), e a idade do paciente está diretamente relacionada ao tempo no qual a dessaturação aparece, ou seja, quanto mais nova a criança, mais rapidamente ela dessatura 18 .…”

Section: A Criança Com Infecção De Vias Aéreas Superiores E a Anestesiaunclassified

“…Most common complications are cough, laryngospasm, bronchospasm and atelectasis 16,17 . Children with upper airway infection submitted to general anesthesia have decreased O 2 reserves 18,19 and a high incidence or laryngospasm (five times higher) 2 and bronchospasm (ten times higher) 3 . The incidence of cough, laryngospasm, bronchospasm and hemoglobin desaturation was increased two to seven fold in patients anesthetized in the presence of upper airway infection, and 11 fold in those needing tracheal intubation 1 .…”

Section: Upper Airway Infection Children and Anesthesiamentioning

confidence: 99%

“…It is important to investigate during preanesthetic evaluation if the child has a history of sleep apnea or snoring 20 . Children with rhinorrhea develop short apnea periods during anesthesia even before oxygen hemoglobin saturation decrease (SpO 2 ), and patients' age is directly related to the moment in which desaturation appears, that is, the younger the child, the faster the desaturation 18 . Children with upper airway infection have transient perioperative SpO 2 decrease 5,19 .…”

Section: Upper Airway Infection Children and Anesthesiamentioning

confidence: 99%

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O paciente com infecção de vias aéreas superiores. Quando anestesiar?

Ganem¹,

Módolo²,

Castiglia³

2003

Rev. Bras. Anestesiol.

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Duration of Apnea in Anesthetized Infants and Children Required for Desaturation of Hemoglobin to 95%

Cited by 84 publications

References 0 publications

Topical lidocaine reduces the risk of perioperative airway complications in children with upper respiratory tract infections

Topical lidocaine reduces the risk of perioperative airway complications in children with upper respiratory tract infections

Bronchodilator premedication does not decrease respiratory adverse events in pediatric general anesthesia

O paciente com infecção de vias aéreas superiores. Quando anestesiar?

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