Department of Anaesthesia, School of Medicine, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.
Department of Anesthesia, College of Health Sciences, Diredawa University, Dire Dawa, Ethiopia.
Paediatr Anaesth. 2021 May;31(5):515-521. doi: 10.1111/pan.14143. Epub 2021 Feb 25.
Tracheal intubation is a common intervention for many pediatric surgical patients. Even though it can be lifesaving, it carries a risk of morbidity and even mortality. Evidence is lacking regarding the adverse events related to pediatric intubation in Ethiopia. This study is aimed to assess the scale of tracheal intubation-related adverse events with its associated factors in pediatrics surgical patients at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.
An Institutional-based cross-sectional study was conducted on 310 pediatric surgical patients who underwent major surgery from December 30, 2019, to February 30, 2020. All pediatrics patients scheduled for surgery under general anesthesia in the study period were included in this study. Data with complete information were entered into Epi Info version 7 and exported to SPSS version 22 for analysis. Descriptive statistics, bivariate, and multivariable logistic regression were computed to identify factors associated with tracheal intubation-related adverse events. The level of statistical significance was declared at a P-value of less than .05.
In this study, the overall incidence of tracheal intubation-related adverse events in pediatrics patients was 36.5%. Being a neonate (AOR = 4.13, 95% CI: 1.26-13.49), emergency surgery (AOR = 3.39, 95% CI: 1.41-8.13), difficult intubation (AOR, 4.08, 95% CI: 1.01-7.50), intubation without using premedication (AOR = 1.75, 95% CI: 1.45-10.83), intubation without using muscle relaxant (AOR = 1.81; 95% CI: 1.10-8.14), and tracheal intubation attempted more than three times (AOR = 3.92, 95% CI: 0.16-7.39) were identified as independent predictors of tracheal intubation-related adverse events.
The incidence of tracheal intubation-related adverse events in pediatric surgical patients is high. Anesthesia professionals should be vigilant and have a preplanned strategy to avoid intubation-related adverse events, especially in high-risk patients. The use of difficult airway algorithms, oxygen saturation monitoring, and training in simulation room are very important strategies to help reduce patient harm.
气管插管是许多小儿外科患者的常见干预措施。尽管它可以挽救生命，但它也存在一定的发病率，甚至死亡率。关于埃塞俄比亚儿科插管相关不良事件的证据尚缺乏。本研究旨在评估提格雷安巴塞萨专科医院小儿外科患者气管插管相关不良事件的严重程度及其相关因素。
这是一项于 2019 年 12 月 30 日至 2020 年 2 月 30 日期间对 310 名接受大手术的小儿外科患者进行的基于机构的横断面研究。研究期间，所有接受全身麻醉下手术的小儿患者均被纳入本研究。将信息完整的资料录入 Epi Info 版本 7 并导出至 SPSS 版本 22 进行分析。采用描述性统计、双变量和多变量逻辑回归分析来识别与气管插管相关不良事件相关的因素。统计显著性水平的判定标准为 P 值<0.05。
在本研究中，小儿患者气管插管相关不良事件的总发生率为 36.5%。新生儿（AOR=4.13，95%CI：1.26-13.49）、急诊手术（AOR=3.39，95%CI：1.41-8.13）、困难插管（AOR=4.08，95%CI：1.01-7.50）、未使用预用药插管（AOR=1.75，95%CI：1.45-10.83）、未使用肌松药插管（AOR=1.81，95%CI：1.10-8.14）和插管尝试次数超过 3 次（AOR=3.92，95%CI：0.16-7.39）被确定为气管插管相关不良事件的独立预测因素。
小儿外科患者气管插管相关不良事件的发生率较高。麻醉专业人员应保持警惕并制定预计划策略，以避免与插管相关的不良事件，特别是在高风险患者中。使用困难气道算法、血氧饱和度监测和模拟室培训是非常重要的策略，可以帮助减少患者伤害。
