title: Effect of general anesthesia on pulmonary function and clinical status on children with cystic fibrosis.
abstract: BACKGROUND
  Children with cystic fibrosis (CF) receive general anesthesia (GA) for a variety of different procedures. Historical studies assessing risk of GA report a high risk of morbidity. There is a paucity of data evaluating the risk of currently available anesthetic agents. The aim of this study was to assess the effect of GA on clinical status and lung function on children with CF.
  
  
  METHODS
  Children with CF aged 8-18 years admitted for IV antibiotic treatment for a pulmonary exacerbation were invited to participate. Spirometry, forced oscillation technique (FOT), and CF clinical score (CFCS) were measured pre-GA, at 24 and 48 h post-GA. The nature and duration of the GA were recorded.
  
  
  RESULTS
  Twenty two patients were recruited of which 19 patients (mean age 11.4 years, range 8-18 years, 12 male) required GA. Typically, either propofol or sevoflurane was used as induction agent and maintenance of anesthesia was with sevoflurane. A laryngeal mask was used in most cases. FEV1 mean (±SD) pre-GA was 75.1% (±23.46) which decreased at 24 h to 74.8 (±23.0) and at 48 h to 74.3 (±20.5). FOT resistance and reactance decreased at 24 and 48 h from baseline. Changes in spirometry and CFCS were not statistically significant. Two adverse events were observed in this cohort.
  
  
  CONCLUSIONS
  The results suggest that children with mild to moderate CF lung disease do not experience significant deterioration in central or peripheral airway function following GA. The low rate of complications suggests an improved level of safety for children with CF with modern anesthesia compared with historical published data.
authors.affiliation: Department of Respiratory medicine, The Children's hospital at Westmead, Sydney, Australia; Discipline of Pediatrics and child health, Sydney Medical School, University of Sydney, Sydney, Australia.
authors.forename: Chetan
authors.initials: C
authors.lastname: Pandit
authors.forename: Roumel
authors.initials: R
authors.lastname: Valentin
authors.forename: Jonathan
authors.initials: J
authors.lastname: De Lima
authors.forename: Paul
authors.initials: P
authors.lastname: Robinson
authors.forename: Dominic
authors.initials: D
authors.lastname: Fitzgerald
authors.forename: Peter
authors.initials: P
authors.lastname: van Asperen
authors.forename: David
authors.initials: D
authors.lastname: Baines
authors.forename: Peter
authors.initials: P
authors.lastname: Cooper
authors.forename: Hiran
authors.initials: H
authors.lastname: Selvadurai
mesh_terms: D000293:Adolescent; D058109:Airway Management; D000768:Anesthesia, General / Q000009:adverse effects*; D018685:Anesthetics, Inhalation; D002648:Child; D015331:Cohort Studies; D003550:Cystic Fibrosis / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D008297:Male; D016343:Monitoring, Intraoperative; D010865:Pilot Projects; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology; D012121:Respiration, Artificial; D012129:Respiratory Function Tests; D013147:Spirometry
chemical_list: D018685:Anesthetics, Inhalation
keywords: PFT testing; child; cystic fibrosis; general anesthesia; measurement; research