title: Salbutamol premedication in children with a recent respiratory tract infection.
abstract: BACKGROUND
  Premedication with beta-2 agonists (e.g. salbutamol) is effective in preventing increases in total respiratory resistance and in decreasing the incidence of perioperative bronchospasm in asthmatic children. Because children with recent respiratory tract infection (RTI) exhibit bronchial hyperreactivity similar to that observed in asthmatic children, the use of salbutamol in children with RTI has become popular among pediatric anesthetists for the prevention of perioperative respiratory adverse events (PRAE). In a prospective observational study, we therefore assessed the usefulness of salbutamol premedication on the occurrence of PRAE.
  
  
  METHODS
  Results from 600 children (0-16 years) undergoing general anesthesia were analyzed: 200 children with a recent RTI who received preoperative salbutamol 10-30 min prior to surgery, 200 children with a recent RTI without salbutamol premedication, and 200 children without a RTI during the last 4 weeks. All PRAE (laryngospasm, bronchospasm, oxygen desaturation [<95%], severe coughing) were recorded.
  
  
  RESULTS
  Children with a recent RTI who received salbutamol demonstrated a significantly reduced incidence of perioperative bronchospasm (5.5% vs 11%, P = 0.0270) and severe coughing (5.5% vs 11.5%, P = 0.0314) compared with children who had an RTI but did not receive salbutamol. However, healthy children presented with the lowest rate (bronchospasm 1.5%, severe coughing 4.5%) of respiratory complications compared with children with a recent RTI independent whether or not they received salbutamol preoperatively.
  
  
  CONCLUSIONS
  The results from this audit suggest that children with a history of a recent RTI have significantly less PRAE following a premedication with salbutamol compared with no premedication. Therefore, premedication with salbutamol might be considered in children with recent RTI.
authors.affiliation: Department of Anesthesia, Princess Margaret Hospital for Children, Perth, WA, Australia. Britta.regli-vonungern@health.wa.gov.au
authors.forename: Britta S
authors.initials: BS
authors.lastname: von Ungern-Sternberg
authors.forename: Walid
authors.initials: W
authors.lastname: Habre
authors.forename: Thomas O
authors.initials: TO
authors.lastname: Erb
authors.forename: Mairead
authors.initials: M
authors.lastname: Heaney
mesh_terms: D000293:Adolescent; D000318:Adrenergic beta-Agonists / Q000008:administration & dosage*; D000420:Albuterol / Q000008:administration & dosage*; D001986:Bronchial Spasm / Q000209:etiology / Q000517:prevention & control*; D002648:Child; D002675:Child, Preschool; D003371:Cough / Q000209:etiology / Q000517:prevention & control; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007431:Intraoperative Complications / Q000517:prevention & control; D007826:Laryngismus / Q000209:etiology / Q000517:prevention & control; D008297:Male; D008485:Medical Audit; D010100:Oxygen / Q000097:blood; D011229:Preanesthetic Medication / Q000379:methods*; D011446:Prospective Studies; D012141:Respiratory Tract Infections / Q000150:complications*; D016896:Treatment Outcome
chemical_list: D000318:Adrenergic beta-Agonists; D000420:Albuterol; D010100:Oxygen