Open AccessShould You Cancel the Operation When a Child Has an Upper Respiratory Tract Infection?
Author(s) -
Marsha M. Cohen,
Cal B. Cameron
Publication year - 1991
Publication title -
anesthesia and analgesia/anesthesia and analgesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.404
H-Index - 201
eISSN - 1526-7598
pISSN - 0003-2999
DOI - 10.1213/00000539-199103000-00002
Subject(s) - medicine , upper respiratory tract infection , perioperative , respiratory tract infections , complication , anesthesia , respiratory tract , respiratory infection , adverse effect , confidence interval , pediatrics , respiratory system , surgery
Cancelling an operation when a child has an upper respiratory tract infection (URI) is not always feasible or practical. Yet we know very little about the additional risk posed by a URI occurring in a child undergoing anesthesia and surgery. Using a large prospectively collected pediatric anesthesia database, we studied 1283 children with a preoperative URI and 20,876 children without a URI. We found that children with a URI were two to seven times more likely to experience respiratory-related adverse events during the intraoperative, recovery room, and postoperative phases of their operative experience. Although these children also experienced significant disruptions in temperature regulation, they were not at risk for any other deleterious events. The elevation in risk after URI as compared with children without a URI was not explained by differences in age, physical status scores, surgical site, and emergency or elective status. However, if a child had a URI and had endotracheal anesthesia, the risk of a respiratory complication increased 11-fold (95% confidence intervals 6.8, 18.1). We conclude that the administration of general anesthesia to children with a URI is not benign and that these children require more observation/management in all perioperative phases of their surgical procedure.