Risk Factors for Perioperative Adverse Respiratory Events in Children with Upper Respiratory Tract Infections

Tait, Alan R.; Malviya, Shobha; Voepel‐Lewis, Terri; Munro, Hamish M.; Siewert, Monica; Pandit, Uma A.

doi:10.1097/00000542-200108000-00008

Cited by 383 publications

(250 citation statements)

References 18 publications

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“…In a large trial by Tait et al, 4 the total airwayrelated complication rate was 30% in children with actual URI and 25% in those with a recent history of URI. In another study, von Ungern-Sternberg et al 17 reported a complication rate of 19% in non-URI patients and nearly 32% in URI patients.…”

Section: Discussionmentioning

confidence: 96%

“…According to the available literature, severe or sustained postoperative coughing in patients with active URI occurs in 4-15% of patients. 4,17 However, severity of coughing as well as occurrence of other airway complications are rather subjective parameters with a marked inter-observer variation. Thus, rather than including only ''severe'' events, we chose to record the incidence of these events regardless of severity.…”

Section: Discussionmentioning

confidence: 99%

“…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%

“…Following the suggestions of other authors, 4,14,15 URI was defined as the presence of at least two of the mentioned symptoms or parents' confirmation of recent or ongoing infection. The anesthesiologist caring for the patient evaluated the presence of a severe URI on the basis of symptoms such as severe coughing, high fever, respiratory distress, and the clinical presentation of the child.…”

Section: Résumémentioning

confidence: 99%

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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: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Section: Résumémentioning

confidence: 99%

Section: Résumémentioning

confidence: 99%

See 2 more Smart Citations

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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“…These cohorts suggest a two-to threefold increase in the RR of transient desaturation in the perioperative period. 62,[65][66][67] Desaturation was variably defined as saturations < 95% to < 90%. A single study that distinguished minor desaturations (# 95%) from major desaturations (# 85%) found no association between URI and the more significant events.…”

Section: Is the Child With Uri At An Increased Risk Of Perioperative mentioning

confidence: 99%

Patient selection in ambulatory anesthesia — An evidence-based review: part II

et al. 2004

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P Pu ur rp po os se e: : This is the second of two reviews evaluating the management of patients with selected medical conditions undergoing ambulatory anesthesia and surgery. Conditions highlighted in this review include: diabetes mellitus; morbid obesity; the ex-premature infant; the child with an upper respiratory infection; malignant hyperthermia; and the use of monoamine oxidase inhibitors.S So ou ur rc ce e: : Medline search strategies and the framework for the evaluation of clinical evidence are presented in Part I. P Pr ri in nc ci ip pa al l f fi in nd di in ng gs s: : Diabetes mellitus has not been linked with adverse events following ambulatory surgery. The morbidly obese patient is at an increased risk for minor respiratory complications in the perioperative period but these events do not increase unanticipated admissions. The ex-premature infant may be considered for ambulatory surgery if post-conceptual age is > 60 weeks and hematocrit is > 30%. The child with a recent upper respiratory tract infection is at an increased risk for perioperative respiratory complications, particularly if endotracheal intubation is required. Patients with malignant hyperthermia may undergo outpatient surgery but require four hours of postoperative temperature monitoring. Sporadic cases of drug interactions have been reported when meperidine and indirectacting catecholamines are administered in the presence of monamine oxidase inhibitors. Ambulatory anesthesia and surgery is safe if these combinations of drugs are avoided.C Co on nc cl lu us si io on n: : Ambulatory anesthesia can be performed in, and is being offered to, a variety of patients with significant coexistent disease. In many cases there is little evidence documenting the outcomes expected in such patients. Prospective observational and interventional trials are required to better define perioperative management. Objectif : C'est la seconde revue qui évalue la prise en charge de patients, dont les pathologies médicales ont été ciblées, qui doivent subir une anesthésie en chirurgie ambulatoire. Les situations choisies comprennent : le diabète, l'obésité morbide, l'enfant né prématurément, l'enfant atteint d'infection des voies respiratoires supérieures, l'hyperthermie maligne et l'usage d'inhibiteurs de la monoamine-oxydase. Source : Les stratégies de recherche dans Medline et le cadre de l'é-valuation de la preuve clinique sont présentés dans la partie I. Constatations principales : Le diabète n'a pas été relié à des événements indésirables à la suite d'une opération ambulatoire. Le patient très obèse est plus à risque de complications respiratoires péri-opératoires mineures, ce qui n'augmente pas les admissions hospitalières imprévues. L'enfant prématuré est admis en chirurgie ambulatoire si l'âge post-conception est > 60 semaines et si l'hématocrite est > 30 %. L'enfant qui a une infection récente des voies respiratoires supérieures

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Anesthesia for Non‐Cardiac Surgery and Magnetic Resonance Imaging

Diaz¹,

Hall²

2005

Anesthesia for Congenital Heart Disease

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Risk Factors for Perioperative Adverse Respiratory Events in Children with Upper Respiratory Tract Infections

Cited by 383 publications

References 18 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

Patient selection in ambulatory anesthesia — An evidence-based review: part II

Anesthesia for Non‐Cardiac Surgery and Magnetic Resonance Imaging

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