Effects of recent upper respiratory-tract infections on incidence of the perioperative respiratory adverse events in children: a prospective cohort study / 北京大学学报(医学版)

ABSTRACT

Objective:To investigate the effects of the recent upper respiratory tract infections (URI) on the incidence of perioperative respiratory adverse events in children scheduled to undergo general anesthesia and elective surgery.Methods:In the study,232 children undergoing general anesthesia with laryngeal mask airway (LMA) for elective ophthalmic surgeries at Peking University First Hospital,Beijing,China,from Nov.1,2015 to May 10,2016 were enrolled.On the day of the surgery,the parents of the children were preoperatively asked to fill out a questionnaire regarding the baseline characteristics and medical history of the children,including gender,age,height,weight,history of URI within the last 2 weeks before anesthesia,history of premature,long-term passive smoking exposure,habitual sleep snoring,and history of asthma.In addition,all adverse respiratory events throughout the perioperative periods (oxygen desaturation,cough,copious secretions,laryngospasm and bronchospasm) as well as perioperative variables (number of attempts to insert the LMA successfully,anesthesia duration and so on) were recorded.Multivariate Logistic regression analysis was applied to identify independent risk factors of perioperative respiratory adverse events.Results:Among the 232 children included in the study,28.0％ (65/232) presented with a history of a recent URI within the last 2 weeks before anesthesia.The presence of the recent URI increased the incidence of oxygen desaturation (23.1％ vs.12.0％,P =0.034),copious secretions (15.4％ vs.6.6％,P =0.036) and any of all the adverse respiratory events (32.3％ vs.18.6％,P =0.024).Multivariate Logistic regression analysis identified two independent risk factors of perioperative adverse respiratory eventsa history of URI within the last 2 weeks before general anesthesia (OR =2.021,95％ CI1.023-3.994,P =0.043) and habitual sleep snoring (OR =3.660,95％ CI1.517-8.832,P =0.004).Conclusion:A history of a recent URI within 2 weeks before general anesthesia was associated with a higher incidence of oxygen desaturation,copious secretions and the overall respiratory adverse events.For the children with recent URI,we recommend the general anesthesia and elective surgery should be postponed for at least 2 weeks after the URI.