Risk factors for laryngospasm in children during general anesthesia
| Autor: | Kevin VanKOEVERDEN, Juraj Sprung, Robert T. Wilder, Darrell R. Schroeder, Randall P. Flick, Mary E. Shirk Marienau, Kyle M. Ellison, Stephen F. Pieper, Andrew C. Hanson |
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| Rok vydání: | 2008 |
| Předmět: |
Male
medicine.medical_treatment Laryngismus Anesthesia General Laryngeal Masks Cohort Studies Postoperative Complications Laryngeal mask airway Risk Factors Odds Ratio medicine Humans Cardiopulmonary resuscitation Laryngospasm Sex Distribution Child Respiratory Tract Infections Retrospective Studies business.industry Respiratory infection Retrospective cohort study Odds ratio medicine.disease Airway Obstruction Anesthesiology and Pain Medicine Upper respiratory tract infection Case-Control Studies Anesthesia Pediatrics Perinatology and Child Health Female medicine.symptom business Airway |
| Zdroj: | Pediatric Anesthesia. 18:289-296 |
| ISSN: | 1460-9592 1155-5645 |
| DOI: | 10.1111/j.1460-9592.2008.02447.x |
| Popis: | Summary Background: Laryngospasm is a common and often serious adverse respiratory event encountered during anesthetic care of children. We examined, in a case control design, the risk factors for laryngospasm in children. Material and Methods: The records of 130 children identified as having experienced laryngospasm under general anesthesia were examined. Cases were identified from those prospectively entered into the Mayo Clinic performance improvement database between January 1, 1996 and December 31, 2005. Potential demographic, patient, surgical and anesthetic related risk factors were determined in a 1 : 2 case–control study. Results: No individual demographic factors were found to be significantly associated with risk for laryngospasm. However, multivariate analysis demonstrated significant associations between laryngospasm and intercurrent upper respiratory infection (OR 2.03 P = 0.022) and the presence of an airway anomaly (OR = 3.35, P = 0.030). Among those experiencing laryngospasm during maintenance or emergence, the use of a laryngeal mask airway was strongly associated even when adjusted for the presence of upper respiratory infection and airway anomaly (P = 0.019). Ten patients experienced postoperatively one or more complications whereas only three complications were observed among controls (P = 0.008). No child required cardiopulmonary resuscitation and there were no deaths in either study cohort. Conclusions: In our pediatric population, the risk of laryngospasm was increased in children with upper respiratory tract infection or an airway anomaly. The use of laryngeal mask airway was found to be associated with laryngospasm even when adjusted for the presence of upper respiratory tract infection and airway anomaly. |
| Databáze: | OpenAIRE |
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