Research: Anesthesia Can Cause Respirator Problems for Children with URIs

Researchers are warning of risks associated with children undergoing surgery that requires general anesthesia if the child has recently had a cold or any upper respiratory infection (URI). They say that this increases the child's risk of having one of several adverse respiratory (breathing-related) events.

The researchers say the risk is low, and serious complications are rare, but if possible waiting two weeks after the child has recovered from a URI can make anesthesia that is delivered by using the laryngeal mask airway (LMA) even safer.

For five months, parents of children who were having any type of surgery that required a general anesthetic were asked to give the researchers information on any recent URIs, for example colds, sinusitis, or tonsillitis. All of the children were given anesthesia an LMA, which is the preferred method for children with recent URI's as opposed to the standard way through the windpipe.

According to the reports from the parents, 27% of the children had experienced a URI within two weeks prior to their surgery and they were almost twice as likely to develop respiratory problems such as a decrease in the blood oxygen level, called desaturation, which was the most common problem, affecting 20% of children and requiring oxygen to be administered in the recovery room. But, even though more of the children who had had a URI than those who did not had a desaturation episode, they were not any more severe in nature.

The children also had a higher rate of laryngospasm, which is a sudden closure of the vocal cords. In the most severe cases, laryngospasm can cause very serious problems with breathing, but none of the children reached the severe level.

They also were at close to double the risk of having problems with coughing after the surgery.

The younger children were more apt to develop the problems and also children who were having surgery on the ear, nose of throat. Also, if it took more than one attempt to insert the LMA.

These conditions occur due to the fact that the child's airway is much more sensitive than it would be if they had not had a URI. The LMA is used because it does snot go through the vocal cords and therefore, it should reduce the risk of laryngospasm and the other events as well.

The anesthesiologist have to do a delicate balancing act. On one hand, there is the risk of performing the surgery on children who have had a recent URI and on the other, there are the economic and emotional factors that would come into play with having to postpone the surgery. And the risks from going ahead with the surgery are not really that well known because there has not been much research done on how long a wait there should be.

In summary, if an LMA is used at the breathing device then the risk of developing detrimental breathing events is greater with the children who have had an URI. But the researchers do say that the overall risk is low and all of the events that happened to the children in the study were taken care of with no problem and there were no lasting effects.

They hope that this study will be of some help to the parents in being able to understand why an anesthesiologist may opt to postpone surgery for at least two week after the child has had the URI.

The lead researcher on the project is Dr. Walid Habre of University Hospitals of Geneva, Switzerland.

Source: American Society of Anesthesiologists (ASA) http://www.newswise.com/p/articles/view/534533/