Perioperative respiratory adverse events in children with active upper respiratory tract infection who received general anesthesia through an orotracheal tube and inhalation agents

Abstract

BackgroundActive upper respiratory tract infection (URI), orotracheal intubation and use of inhalation anesthetics are known risk factors for perioperative respiratory adverse events (RAE). This study investigated the risk factors of perioperative RAE in children with these risk factors.MethodsThe records of 159 children who underwent general anesthesia with an orotracheal tube and inhalation were reviewed. These patients also had at least one of the following URI symptoms on the day of surgery: clear or green nasal secretion, dry or moist cough, nasal congestion, or fever. RAE such as laryngospasm, bronchospasm, oxygen desaturation and sustained cough were collected before induction, during intubation, during extubation, after extubation and in the postanesthesia care unit.ResultsForty-five patients had RAE. The patients with RAE were younger than those without RAE. There were more passive smokers and a greater number of intubation attempts in patients with RAE than in those without RAE. The type of surgery and type of inhalation agents were not different between patients with and without RAE. Passive smoking was the only independent risk factor for RAE.ConclusionsIn children with an active URI using orotracheal tube and inhalation anesthetics, passive smoking is an important risk factor for RAE.

Preoperative Upper Respiratory Tract Infections and Pediatricians’ Perspective in Terms of Anesthesia

“…Although URTIs are usually regarded as benign under most other circumstances, even clear nasal secretion is a very important trigger for PAEs, as also shown by a previous study (3). Similarly, increased secretions were the parameter most commonly reported by our pediatricians as a risk factor in anesthetic management.…”

“…Endotracheal intubation and use of inhalation anesthetics increase the risk of perioperative adverse events (PAE), and the presence of active or recent URTI exacerbates PAE. Approximately one-third of children with URTI experience laryngospasm, bronchospasm, oxygen desaturation, and sustained cough during perioperative periods (3). The incidence of dysphoria and copious sputum also increases significantly in these children (4).…”

Impact of environmental tobacco smoke exposure on anaesthetic and surgical outcomes in children: a systematic review and meta-analysis

“…The anaesthetic outcome studies used a wide range of surgical groups, including general or mixed surgery, 15 18–20 22–24 27 41 dental, 25 ophthalmology 16 and urology 17 patients.…”

Manejo perioperatorio de niños con infección respiratoria superior

“…Estudios observacionales han mostrado un descenso importante del riesgo de EARP entre la segunda y la cuarta semana y un riesgo no significativo tras cuatro semanas de iniciado el proceso infeccioso (3,7,17,18). Otros factores que podrían contribuir a la aparición de dichos eventos adversos se describen en la Tabla 1 (19)(20)(21)(22)(23)(24)(25)(26). Tabla 1.…”