The risk factors of intraoperative anesthesia adverse events in children with laryngeal diseases.
BACKGROUND
This study aimed to investigate the risk factors of intraoperative anesthesia adverse events (IAAEs) in children with laryngeal diseases.


METHODS
We retrospectively recruited 118 children with laryngeal diseases who underwent surgical therapy. Based on medical history and preoperative imaging diagnosis, the baseline data, including sex, age, weight, onset age, the number of operation, the degree of airway obstruction, the nature of disease, the location of disease, complications, tracheotomy, and trachea intubation, were defined and recorded. IAAEs, such as pulse oxygen saturation (SpO2) decline, heart rate (HR) decline, emergency orotracheal intubation, emergency tracheotomy, and remaining intubated postoperatively, were also recorded. The risk factors for IAAEs were identified using multivariate logistic regression model.


RESULTS
Increasing severity of airway obstruction and the presence of pneumonia were risk factors for SpO2 and HR decline in children with laryngeal diseases. Older age, supraglottic rather than subglottic disease, and trachea intubation rather than unprotected airway during surgery were protective factors for SpO2 decline. Furthermore, severe airway obstruction increased risks of emergency orotracheal intubation and remaining intubated postoperatively, whereas supraglottic rather than subglottic disease were protective factors for emergency orotracheal intubation and remaining intubated postoperatively. Only HR decline was found to be associated with the presence of congenital heart disease.


CONCLUSIONS
The severe airway obstruction increases the risk of SpO2 decline and HR decline as well as the possibility of perioperative emergency orotracheal intubation and remaining intubated postoperatively, whereas supraglottic surgery and surgery performed under endotracheal intubation reduce the incidence rates of these IAAEs in children with laryngeal diseases.
Department of Anesthesiology and Critical Care Medicine, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 20092, China. Electronic address: yangliqiao2323@hotmail.com.
Yang
Y
Li-Qiao
Department of Anesthesiology, Shanghai Children's Medical Center Affiliated to Jiao Tong University School of Medicine, Shanghai 200127, China. Electronic address: Janewei0704@hotmail.com.
Zhang
Z
Jian-Wei
Department of Anesthesiology and Critical Care Medicine, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 20092, China. Electronic address: lijjjjddgd@hotmail.com.
Li
L
Jing-Jie
Department of Anesthesiology and Critical Care Medicine, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 20092, China. Electronic address: zhanggdgcf@sina.com.
Zhang
Z
Cheng-Mi
D000402:Airway Obstruction / Q000150:complications; D000768:Anesthesia, General / Q000009:adverse effects*; D001785:Blood Gas Monitoring, Transcutaneous; D005260:Female; D006339:Heart Rate; D006801:Humans; D015994:Incidence; D007223:Infant; D007431:Intraoperative Complications / Q000097:blood / Q000453:epidemiology* / Q000209:etiology; D007442:Intubation, Intratracheal / Q000706:statistics & numerical data; D007818:Laryngeal Diseases / Q000150:complications / Q000601:surgery*; D008297:Male; D010100:Oxygen / Q000097:blood; D011014:Pneumonia / Q000150:complications; D012189:Retrospective Studies; D012307:Risk Factors; D014139:Tracheostomy / Q000706:statistics & numerical data
D010100:Oxygen
Airway obstruction; Endotracheal intubation; Intraoperative anesthesia adverse events; Pediatric laryngeal diseases; Risk factors