Site-directed topical lidocaine spray attenuates perioperative respiratory adverse events in children undergoing elective surgery

Li, Liwei; He, Liangmei; Ai, Yanqiu; Chu, Qinjun; Zhang, Wei

doi:10.1016/j.jss.2016.03.011

Cited by 10 publications

(4 citation statements)

References 25 publications

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“…Clinicians have explored various strategies to minimize PRAEs, including but not limited to the use of laryngeal mask airways, intravenous induction of anesthesia (vs mask induction), and lidocaine topicalization of the airway. [8][9][10] However, preoperative strategies are needed to provide anesthesiologists a comprehensive approach for high-risk children.…”

Section: Introductionmentioning

confidence: 99%

Effect of Intranasal Dexmedetomidine or Midazolam for Premedication on the Occurrence of Respiratory Adverse Events in Children Undergoing Tonsillectomy and Adenoidectomy

Shen

Zhang

et al. 2022

JAMA Netw Open

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Section: Introductionmentioning

confidence: 99%

Effect of Intranasal Dexmedetomidine or Midazolam for Premedication on the Occurrence of Respiratory Adverse Events in Children Undergoing Tonsillectomy and Adenoidectomy

Shen

Zhang

et al. 2022

JAMA Netw Open

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“…A total of 571 records were identified through database searching and other sources, the full texts of 50 articles were examined in detail. And finally we included 12 RCTs 3 4 5 9 10 11 12 13 14 15 16 17 with a total of 1416 participants. Searching process was shown in the flowchart ( Fig.…”

Section: Resultsmentioning

confidence: 99%

The Efficacy of Lidocaine in Laryngospasm Prevention in Pediatric Surgery: a Network Meta-analysis

Lai

et al. 2016

Sci Rep

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Higher incidence and worse outcomes of laryngospasm during general anesthesia in children than adults have been reported for many years, but few prevention measures are put forward. Efficacy of lidocaine in laryngospasm prevention has been argued for many years and we decided to design this network meta-analysis to assess the efficacy of lidocaine. We conducted an electronic search of six sources and finally included 12 Randomized Controlled Trials including 1416 patients. A direct comparison between lidocaine and placebo revealed lidocaine had the effect on preventing laryngospasm in pediatric surgery (RR = 0.46, 95% CI = [0.30, 0.70], P = 0.0002, I2 = 0%). Both subgroup analysis and network analysis demonstrated that both intravenous lidocaine (subgroup: RR = 0.39, 95% CI = [0.18, 0.86], P = 0.02, I2 = 38%; network: RR = 0.25, 95% CI = [0.04, 0.86]) and topical lidocaine (subgroup: RR = 0.37, 95% CI = [0.19, 0.72], P = 0.003, I2 = 0%; network: RR = 0.14, 95% CI = [0.02, 0.55]) was effective in laryngospasm prevention, while no statistical difference was found in a comparison between intravenous and topical lidocaine. In conclusion, both intravenous and topical lidocaine are effective in laryngospasm prevention in pediatric surgery, while a comparison between them needs more evidences.

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“…The underlying biological mechanism is that atropine usage can reduce the production of airway secretions, thereby reducing the risk of RAEs. In the previous literature, the premedication used to prevent or minimize RAEs mainly includes sedative drugs and local anesthetics, such as dexmedetomidine, midazolam, and lidocaine topicalization of the airway ( 3 , 7 , 26 – 28 ). In our published study, we have confirmed that premedication with intranasal dexmedetomidine was an effective method to decrease the occurrence of RAEs in children with CHD ( 28 ).…”

Section: Discussionmentioning

confidence: 99%

A novel nomogram for predicting respiratory adverse events during transport after interventional cardiac catheterization in children

Tong

Liu²,

Zhang³

et al. 2022

Front. Pediatr.

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ObjectiveThe rate and predictors of respiratory adverse events (RAEs) during transport discharged from operating room after interventional cardiac catheterization in children remain unclear. This study aimed to investigate the incidence and predictors, and to construct a nomogram for predicting RAEs during transport in this pediatric surgical treatment.MethodsThis prospective cohort study enrolled 290 consecutive pediatric patients who underwent ventricular septal defects (VSD), atrial septal defects (ASD), and patent ductus arteriosus (PDA) between February 2019 and December 2020. Independent predictors were used to develop a nomogram, and a bootstrap resampling approach was used to conduct internal validation. Composite RAEs were defined as the occurrence of at least 1 complication regarding laryngospasm, bronchospasm, apnea, severe cough, airway secretions, airway obstruction, and oxygen desaturation.ResultsThe rate of RAEs during transport was 23.1% (67 out of 290). Multivariate analysis identified age (vs. ≤3 years, adjusted odds ratio (aOR) = 0.507, 95% conﬁdence interval (CI), 0.268–0.958, P = 0.036), preoperative upper respiratory tract infections (URI, aOR = 2.335, 95% CI, 1.223–4.460, P = 0.01), type of surgery (vs. VSD, for ASD, aOR = 2.856, 95% CI, 1.272–6.411, P = 0.011; for PDA, aOR = 5.518, 95% CI, 2.425–12.553, P < 0.001), morphine equivalent (vs. ≤0.153 mg/kg, aOR = 2.904, 95% CI, 1.371–6.150, P = 0.005), atropine usage (aOR = 0.463, 95% CI, 0.244–0.879, P = 0.019), and RAEs during extubation to transport (aOR = 5.004, 95% CI, 2.633–9.511, P < 0.001) as independent predictors of RAEs during transport. These six candidate predictors were used to develop a nomogram, which showed a C-statistic value of 0.809 and good calibration (P = 0.844). Internal validation revealed similarly good discrimination (C-statistic, 0.782; 95% CI, 0.726–0.837) and calibration. Decision curve analysis (DCA) also demonstrated the clinical usefulness of the nomogram.ConclusionThe high rate of RAEs during transport reminds us of the need for more medical care and attention. The proposed nomogram can reliably identify pediatric patients at high risk of RAEs during transport and guide clinicians to make proper transport plans. Our findings have important and meaningful implications for RAEs risk prediction, clinical intervention and healthcare quality control.

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Site-directed topical lidocaine spray attenuates perioperative respiratory adverse events in children undergoing elective surgery

Cited by 10 publications

References 25 publications

Effect of Intranasal Dexmedetomidine or Midazolam for Premedication on the Occurrence of Respiratory Adverse Events in Children Undergoing Tonsillectomy and Adenoidectomy

Effect of Intranasal Dexmedetomidine or Midazolam for Premedication on the Occurrence of Respiratory Adverse Events in Children Undergoing Tonsillectomy and Adenoidectomy

The Efficacy of Lidocaine in Laryngospasm Prevention in Pediatric Surgery: a Network Meta-analysis

A novel nomogram for predicting respiratory adverse events during transport after interventional cardiac catheterization in children

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