Predictors of perioperative respiratory adverse effects during pediatric anesthesia

Upper respiratory tract infections (URIs) are frequently encountered as preoperative comorbidities during pediatric anesthesia. URIs are associated with perioperative respiratory adverse effects (PRAE). However, no definite guidelines exist for postponing anesthesia. Therefore, deciding whether to proceed with anesthesia during the treatment of patients with URIs can be difficult. The aim of this study was to evaluate predictors of PRAE during pediatric anesthesia in patients with URIs. Data were collected from the medical charts and anesthesia records of pediatric patients under the age of 10 years. All the patients had undergone oral maxillofacial surgery and/or dental treatment under general anesthesia between September 2009 and October 2012 at Kyushu University Hospital. The collected data included sex, age, body weight, height, duration of anesthesia, type of dental procedure, and general condition as assessed using the common cold score. Patients were divided into two groups : A PRAE group (n = 150), and a non-PRAE group (n = 441).A binomial logistic regression analysis was performed for the above factors. The following factors exhibited a statistically significant relationship with the incidence of PRAE : nasal obstruction (odds ratio = 5.49 I p<0.001 ; 95%CI, 2.38- 12.67), coughing (odds ratio = 7.15; p = 0.001; 95%CI, 2.30- 22.25), an elevated WBC (odds ratio = 5.77; p<0.001 ; 95% CI, 3.20-10.39), and a history of a common cold within the previous 2 weeks (odds rat io = 8.05; p = 0.001; 95% CI, 2.29- 28.37). These results may help physicians to decide whether to use anesthesia or to postpone treatment.