Upper respiratory tract infections and general anaesthesia in children

Levy, Loren; Pandit, Uma A.; Randel, Gail I.; Lewis, I.H.; Tait, Alan R.

doi:10.1111/j.1365-2044.1992.tb02389.x

Cited by 66 publications

(31 citation statements)

References 12 publications

(5 reference statements)

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“…62,66,68 Episodes of laryngospasm or bronchospasm in these studies were no more frequent or severe in those with URI. True outcomes such as unanticipated hospital admission, pneumonia, and death were rare.…”

Section: How Serious Are the Respiratory Complications Associated Witmentioning

confidence: 78%

“…60,66 In Tait's prospective cohort of over 1,000 children the definition of "recent" was extended to four weeks. The incidence of adverse respiratory events was 30% in the active URI group, 24.2% in those with symptoms in the past four weeks, and 18% in the control group.…”

Section: How Long After An Uri Should Surgery Be Delayed?mentioning

confidence: 99%

“…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%

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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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Section: How Serious Are the Respiratory Complications Associated Witmentioning

confidence: 78%

Section: How Long After An Uri Should Surgery Be Delayed?mentioning

confidence: 99%

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

confidence: 99%

See 1 more Smart Citation

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

et al. 2004

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“…HE association between a recent upper respiratory tract infection (URI) and respiratory adverse events, such as bronchospasm, laryngospasm, and hemoglobin desaturation during general anesthesia, has been documented both retrospectively [1][2][3][4] and prospectively. [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.…”

mentioning

confidence: 99%

“…[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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