Those found at high risk for respiratory events could benefit from tailored management
FRIDAY, Sept. 3 (HealthDay News) -- Children at increased risk for perioperative respiratory adverse events can be identified via a pre-anesthesia questionnaire, which could allow them to benefit from tailored anesthesia management, according to a study published in the Sept. 4 issue of The Lancet in advance of the European Respiratory Society Annual Congress, to be held from Sept. 18 to 22 in Barcelona, Spain.
In a prospective cohort study, Britta S. von Ungern-Sternberg, Ph.D., of the Princess Margaret Hospital for Children in Perth, Australia, and colleagues evaluated children who had undergone general anesthesia for surgical or medical interventions from Feb. 1, 2007, to Jan. 31, 2008. Anesthetists completed an adapted version of the International Study Group for Asthma and Allergies in Childhood questionnaire on the day of the procedure (9,297 questionnaires were available for analysis).
The investigators found that children with a history of nocturnal dry cough, wheezing during exercise, wheezing more than three times in the past 12 months, or current or past eczema had a higher risk for bronchospasm (relative risk [RR], 8.46), laryngospasm (RR, 4.13) and perioperative cough, desaturation, or airway obstruction (RR, 3.05). In addition, present or recent (within two weeks) upper respiratory tract infection was associated with an increased risk of respiratory adverse events (RRs, 2.05 and 2.34, respectively). The risk of perioperative respiratory adverse events was also higher among children with a history of at least two family members having asthma, atopy, or smoking. The authors concluded that children identified as high risk through the pre-anesthesia assessment could benefit from specifically targeted anesthesia management.
"Children at high risk of perioperative respiratory adverse events might benefit from anesthesia management, including a specialist pediatric anesthetist, intravenous induction and maintenance with propofol, and avoidance of tracheal tube for airway management when possible," the authors write.
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