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Research Article Open access CC BY 4.0

Association between Intraoperative and Post-Anesthetic Care Unit Respiratory Events among 12,641 Children in Southern Thailand

Maliwan Oofuvong, F. Alan Geater, Virasakdi Chongsuvivatwong, Ngamjit Pattaravit, Kanjana Nuanjun

Journal of Advances in Medicine and Medical Research · pp. 1101–1112 · Published 28 Jan 2015

10.9734/BJMMR/2015/15789

Abstract

Aims: The association between intraoperative respiratory events (IRE) and post-anesthetic care unit respiratory events (PARE) in children as well as the risk factors for PARE have not been described. The objectives of this study were to describe the association between IRE and PARE and to identify the risk factors of PARE in children at a tertiary care hospital in southern Thailand. Methodology: A historical cohort study based on the surveillance anesthetic database and chart review of children who received surgery at Songklanagarind Hospital during January 2005 to December 2011 was conducted. Demographic, surgery and anesthesia-related data were collected. The association between IRE and PARE and other potential risk factors were analyzed using cross tabulation. Multivariate logistic regression was employed to identify independent predictors for PARE, indicated by adjusted odds ratios (aOR) and their 95% confidence intervals (CI). Results: Overall, perioperative respiratory event (PRE) occurred in 531 out of 14153 children (315 IRE, 348 PARE). The association between PARE and IRE was strong, with adjusted odds ratios ranging from 3.1 (laryngospasm) to 18.5 (desaturation). Anesthesia-related risk factors for PARE were ASA classification 3 (aOR=3.1, 95%CI=1.9-5.0), jet ventilation (aOR=3.4, 95%CI=1.6-7.1), intubation with succinylcholine vs non-depolarizing muscle relaxant (aOR=1.9, 95%CI=1.4-2.5), use of intraoperative morphine vs fentanyl (aOR=2.4, 95%CI=1.7-3.3) and duration of anesthesia ≥ 3 hours (aOR=3.2, 95%CI=2.1-4.9). Conclusion: The magnitude of association between IRE and PARE was high. Increased vigilance and close monitoring by anesthesia personnel in high risk children and high risk surgery may prevent IRE and therefore also PARE, so that overall PRE can be reduced. Preventable risk factors for PARE such as using succinylcholine and morphine can be managed under discretion of the anesthesiologist.

Intraoperative period post-anesthetic care unit respiratory events pediatric anesthesia tertiary care hospital.

References (22)

  1. 1 Anesthesia-Related Cardiac Arrest in Children: Update from the Pediatric Perioperative Cardiac Arrest Registry [DOI]
  2. 2 Risk assessment for respiratory complications in paediatric anaesthesia: a prospective cohort study [DOI]
  3. 3 Risk Factors for Perioperative Adverse Respiratory Events in Children with Upper Respiratory Tract Infections [DOI]
  4. 4 Incidence and risk factors of perioperative respiratory adverse events in children undergoing elective surgery [DOI]
  5. 5 Recurrent Hypoxemia in Children Is Associated with Increased Analgesic Sensitivity to Opiates [DOI]
  6. 6 Pharmacology of Muscle Relaxants and Their Antagonists [DOI]
  7. 7 Recurrent Hypoxemia in Young Children with Obstructive Sleep Apnea Is Associated with Reduced Opioid Requirement for Analgesia [DOI]
  8. 8 Incidence and Risk Factors for Perioperative Adverse Respiratory Events in Children Who Are Obese [DOI]
  9. 9 Perioperative outcomes of severely obese children undergoing tonsillectomy [DOI]
  10. 10 Anesthesia in children with a cold [DOI]
  11. 11 The Risk Factors for Hypoxemia in Children Younger than 5 Years Old Undergoing Rigid Bronchoscopy for Foreign Body Removal [DOI]
  12. 12 Risk factors for reintubation in the post-anaesthetic care unit: a case–control study [DOI]
  13. 13 Cardiac arrest in anesthetized children: recent advances and challenges for the future [DOI]
  14. 14 Risk factors for perioperative adverse events in children with myotonic dystrophy [DOI]
  15. 15 Intraoperative respira-tory complications in patients with upper respiratory tract infections [DOI]
  16. 16 Study of the safe threshold of apneic period in children during anesthesia induction [DOI]
  17. 17 Pediatric anesthesia adverse events: the Thai Anesthesia Incidents Study (THAI Study) database of 25,098 cases.
  18. 18 Incidence of laryngospasm and bronchospasm in pediatric adenotonsillectomy [DOI]
  19. 19 Incidence and causes of perioperative endotracheal reintubation in children: a review of 28 208 anesthetics [DOI]
  20. 20 Risk over time and risk factors of intraoperative respiratory events: a historical cohort study of 14,153 children [DOI]
  21. 21 Risk Factors for Perioperative Adverse Respiratory Events in Children With Upper Respiratory Tract Infections [DOI]
  22. 22 Perioperative desaturation and risk factors in general anesthesia.

Cited by 3

Risk prediction tool for use and predictors of duration of postoperative oxygen therapy in children undergoing non-cardiac surgery: a case-control study

Maliwan Oofuvong, Siriwimol Ratprasert, Thavat Chanchayanon · BMC Anesthesiology · 2018

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