Department of Respiratory and Sleep Medicine, Perth Children's Hospital, Nedlands, WA, Australia.
Division of Paediatrics, School of Medical, University of Western Australia, Crawley, WA, Australia.
Paediatr Anaesth. 2022 Feb;32(2):191-201. doi: 10.1111/pan.14356. Epub 2021 Dec 10.
Perioperative respiratory adverse events pose a significant risk in pediatric anesthesia, and identifying these risks is vital. Traditionally, this is assessed using history and examination. However, the perioperative risk is multifactorial, and children with complex medical backgrounds such as chronic lung disease or obesity may benefit from additional objective preoperative pulmonary function tests. This article summarizes the utility of available pulmonary function assessment tools as preoperative tests in improving post-anesthetic outcomes. Currently, there is no evidence to support or discourage any pulmonary function assessment as a routine preoperative test for children undergoing anesthesia. In addition, there is uncertainty about which patients with the known or suspected respiratory disease require preoperative pulmonary function tests, what time period prior to surgery these are required, and whether spirometry or more sophisticated tests are indicated. Therefore, the need for any test should be based on information obtained from the history and examination, the child's age, and the complexity of the surgery.
围手术期呼吸不良事件是小儿麻醉的重大风险，识别这些风险至关重要。传统上，这是通过病史和检查来评估的。然而，围手术期的风险是多因素的，患有慢性肺部疾病或肥胖等复杂医疗背景的儿童可能受益于额外的术前客观肺功能测试。本文总结了现有肺功能评估工具作为术前检查在改善麻醉后结果方面的作用。目前，没有证据支持或反对将任何肺功能评估作为接受麻醉的儿童的常规术前检查。此外，对于已知或疑似呼吸疾病的患者，哪些患者需要术前肺功能检查、手术前需要多长时间进行这些检查以及是否需要肺活量计或更复杂的检查，存在不确定性。因此，任何检查的必要性都应基于病史和检查、儿童年龄以及手术的复杂性所获得的信息。
