Anaesthetic risks in children with obstructive sleep apnea syndrome undergoing adenotonsillectomy.
OBJECTIVE
To determine the frequency of anaesthetic risks in children having Obstructive Sleep Apnea Syndrome (OSAS), undergoing adenotonsillectomy.


METHODS
A case-control study.


METHODS
Department of Anaesthesiology, Armed Forces Hospital, Najran, Saudi Arabia from November 2006 to January 2008.


METHODS
The study was carried out in 60 children scheduled to undergo adenotonsillectomy and divided into two equal groups of 30 each. Group-1 had obstructive sleep apnoea syndrome and group-2 had children without it. Both groups were given a standard general anaesthesia and frequency and rate of complications and medical interventions taken in such children were studied. P-value and odds ratio were determined.


RESULTS
The age ranged from 3 to 10 years. The frequency of difficult intubation was higher in the group-1 than in the control group (16.6 vs. 3.3%, odds ratio 5.8). At the time of induction of anaesthesia desaturation was higher in group-1 (33.3 vs. 6.6%, p=0.021, odds ratio 7). At the time of extubation, desaturation was significantly higher in group-1 (43.3 vs. 6.6%, p=0.002, odds ratio 10.70). The complications at extubation, for example cough, laryngospasm and postoperative nausea and vomiting were higher in group-1 but not statistically significant. In the postanaesthesia care unit, the frequency of complications and medical interventions were also higher in group-1. More patients of group-1 required oxygen (63.3 vs. 10%, p < 0.001, odds ratio 15.54) and insertion of an oropharyngeal airway (20% vs. nil, p=0.023) respectively.


CONCLUSIONS
Children with OSAS, operated for adenotonsillectomy, are at significant risk of certain life-threatening perioperative anaesthetic complications. These results may be used as a guideline for safe and successful anaesthetic management of these children.
Riaz
Azmat
A
Department of Anaesthesiology, Armed Forces Hospital, Najran, Kingdom of Saudi Arabia. azmatrt@yahoo.com
Malik
Hamid Saeed
HS
Fazal
Nadeem
N
Saeed
Mohammad
M
Naeem
Saquib
S
D000233:Adenoidectomy / Q000009:adverse effects*; D000367:Age Factors; D000768:Anesthesia, General / Q000009:adverse effects; D000777:Anesthetics / Q000009:adverse effects*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D016017:Odds Ratio; D010092:Oximetry; D019990:Perioperative Care / Q000009:adverse effects; D011183:Postoperative Complications / Q000209:etiology*; D015656:Respiratory Mechanics / Q000502:physiology; D012306:Risk; D012529:Saudi Arabia; D020181:Sleep Apnea, Obstructive / Q000503:physiopathology / Q000601:surgery*; D014068:Tonsillectomy / Q000009:adverse effects*; D016896:Treatment Outcome
D000777:Anesthetics