[Preoperative assessment of children with fever and common cold: to proceed, or not to proceed, that is the question].
Fever and upper respiratory tract infections (URI) are frequently-encountered preoperative comorbidities. Whether or not to proceed with anesthesia for a child with common cold is still a continuing dilemma for anesthesiologists. We, anesthesiologists often feel uncomfortable in making a decision whether or not to proceed because URI is associated with perioperative respiratory adverse events (PRAEs) and there are no definite rules to proceed with or postpone a case. Most of PRAEs are easily managed by experienced hands; however, laryngospasm or bronchospasm without early detection and immediate treatment would probably result in serious sequelae. Although several factors (e. g., asthma, infancy, endotracheal intubation, airway surgery, parental smoking, and parental confirmation of a URI, etc.) related to PRAEs have been elucidated to date, no one can guess correctly which child will suffer from adverse events. Moreover, because children per se are vulnerable to PRAEs, we cannot reduce the risk to zero even without a URI. Therefore, we should be familiarized with how to cope with PRAEs. In making a decision to proceed with or postpone the case, it is important to take various factors together into account, and the decision ultimately depends on whether or not we feel "Yes, we can".
Department of Anesthesia, Kanagawa Children's Medical Center, Yokohama 232-8555.
Yoshihisa
Y
Miyamoto
Koui
K
Ka
D002648:Child; D003139:Common Cold / Q000175:diagnosis; D003657:Decision Making; D005334:Fever / Q000175:diagnosis; D006801:Humans; D011300:Preoperative Care; D012141:Respiratory Tract Infections / Q000175:diagnosis*