Frequency and severity of desaturation events during general anesthesia in children with and without upper respiratory infections.
OBJECTIVE
To determine whether anesthesia in the presence of a mild upper respiratory infection (URI) was associated with episodes of desaturation or reactive airway problems.


METHODS
A prospective study.


METHODS
Inpatient and outpatient units of a university medical center.


METHODS
Four hundred two pediatric patients.


METHODS
Patients were monitored with continuous recordings of oxygen saturation (SpO2), capnography, and electrocardiogram. A separate anesthesiologist was present throughout each case to observe for complications and interview the anesthesia team. The decision to anesthetize patients with a URI was left to the discretion of the anesthesia team.


RESULTS
Thirty patients with a URI and 372 patients without one were studied. One hundred ninety-six patients were managed with endotracheal intubation and 206 with face mask; 15 in each group had a URI. There was no increase in major desaturation events (SpO2 of 85% or less for 30 or more seconds) but minor desaturation events (SpO2 of 95% or less for 60 or more seconds) were increased (p = 0.02). There was no increased frequency of laryngospasm (1 in 30 vs. 22 in 372), but there was a higher frequency of bronchospasm in intubated patients (2 in 15 vs. 1 in 181; p = 0.016).


CONCLUSIONS
Children with a mild URI have an increased frequency of minor desaturation episodes, and intubated patients with a URI have an increased frequency of bronchospasm. It appears that children with a mild URI may be safely anesthetized, since the problems encountered are generally easily treated and without long-term sequelae.
Rolf
N
N
Department of Anesthesia, Massachusetts General Hospital, Boston 02114.
Coté
C J
CJ
D000768:Anesthesia, General; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D010100:Oxygen / Q000097:blood*; D011446:Prospective Studies; D012141:Respiratory Tract Infections / Q000097:blood* / Q000453:epidemiology / Q000503:physiopathology
D010100:Oxygen