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Pediatric Anesthesia
Anesthesia and Pain Medicine 2012;7(1):80-86.
Published online January 31, 2012.
Risk factors for perioperative respiratory adverse events in pediatric anesthesia; multicenter study
So Ron Choi, Byung Ju Ko, Chan Jong Chung, Mijeung Gwak, Gaabsoo Kim, Hee Soo Kim, Sung Sik Park, Tae Hun An, Il Ok Lee, Jong Hwa Lee, Ji Young Lee, Chul Ho Chang, Jong In Han
1Department of Anesthesiology and Pain Medicine, Dong-A University College of Medicine, Busan, Korea. cjchung@dau.ac.kr
2Department of Anesthesiology and Pain Medicine, University of Ulsan College of Medicine, Seoul, Korea.
3Department of Anesthesiology and Pain Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea.
4Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, Korea.
5Department of Anesthesiology and Pain Medicine, Kyungpook National University School of Medicine, Daegu, Korea.
6Department of Anesthesiology and Pain Medicine, School of Medicine, Chosun University, Gwangju, Korea.
7Department of Anesthesiology and Pain Medicine, Korea University School of Medicine, Seoul, Korea.
8Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Korea.
9Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
10Department of Anesthesiology and Pain Medicine, Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea.
11Department of Anesthesiology and Pain Medicine, Ewha Womans University School of Medicine, Seoul, Korea.
Abstract
BACKGROUND
Perioperative respiratory adverse events remain a major cause of postoperative morbidity and mortality during pediatric anesthesia. This multicenter study was designed to evaluate the incidence of perioperative respiratory adverse events during elective pediatric surgery and to identify the risk factors for these events.
METHODS
Pediatric patients undergoing elective surgery under general anesthesia in 11 hospitals were randomly selected for this prospective, multicenter study. Preanesthetic assessments, anesthetic and surgical conditions were recorded by anesthesiologists in charge. Adverse respiratory events were registered.
RESULTS
Eight hundred and twenty-three patients were included. The overall incidence of any perioperative respiratory adverse respiratory event was 15.1%. The incidences of perioperative bronchospasm, laryngospasm, coughing, desaturatioin (oxygen saturation <95%), and airway obstruction were 0.1, 0.5, 10.2, 4.1, and 1.6% respectively. According to the multivariate analysis, five risk factors were identified: multiple attempts for airway device insertion, odds ratio (OR) 2.88; recent URI (< or =2 weeks), OR 1.96; induction with intravenous anesthetics, OR 1.95; airway related surgery, OR 1.88; ASA class > or =2, OR 1.62.
CONCLUSIONS
Multiple attempts for airway device insertion, recent URI, induction with intravenous anesthetics, airway related surgery and ASA class > or =2 were associated with increased risk for perioperative respiratory adverse events.
Key Words: Anesthesia, Children, Complications, Morbidity
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