title: Frequency and severity of desaturation events during general anesthesia in children with and without upper respiratory infections.
abstract: 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.
authors.affiliation: Department of Anesthesia, Massachusetts General Hospital, Boston 02114.
authors.forename: N
authors.initials: N
authors.lastname: Rolf
authors.forename: C J
authors.initials: CJ
authors.lastname: Coté
mesh_terms: 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
chemical_list: D010100:Oxygen