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SARS-CoV-2 感染患儿的麻醉 - 单中心经验。一项病例对照研究。

Anaesthesia in  SARS-CoV-2 infected children - single-centre experience. A case-control study.

机构信息

Department of Pediatric Anesthesiology and Intensive Care, Pediatric Teaching Hospital, University Clinical Center Warsaw Medical University, Warsaw, Poland.

Medical University of Warsaw, Warsaw, Poland.

出版信息

Anaesthesiol Intensive Ther. 2023;55(3):223-228. doi: 10.5114/ait.2023.130791.

Abstract

INTRODUCTION

Although manifestation of SARS-CoV-2 infection in children is gene-rally mild or asymptomatic, anaesthetic implications of the infection in children are still a matter of concern. Single reports suggest that patients with SARS-CoV-2 infection are at higher risk of anaesthetic complications.

MATERIAL AND METHODS

We performed a retrospective, case control study analysing the risk of general anaesthesia in SARS-CoV-2 infected children admitted to a tertiary paediatric university hospital for the purpose of urgent procedures requiring anaesthesia  between April 1st and September 30 th , 2021. The control group consisted of  SARS-CoV-2 negative children consecutively anaesthetised for the same reasons during the first month of observation. Our hypothesis was: general anaesthesia can be safely performed in SARS-CoV-2 infected children. Study endpoints: primary - anaesthetic respiratory complications (bronchospasm, laryngospasm, intraoperative desaturation below 94%, desaturation below 94% after awakening, unplanned postoperative mechanical ventilation); secondary - hospital length of stay, thrombotic, cardiac, haemorrhagic events, ICU admission, deaths during hospitalisation.

RESULTS

The examined group consisted of 58 SARS-CoV-2 infected children, the matched control group of 198 patients. The rate of complications in both groups was very low, with no significant difference between the groups. The only differences observed were a higher frequency of desaturations in the awakening period and longer time of hospitalisation in SARS-CoV-2 infected patients. Multivariate logistic regression analysis showed that physical status of the patient and duration of the procedure were the main factors influencing the risk of complications.

CONCLUSIONS

In our experience anaesthesia of SARS-CoV-2 infected children can be safely performed.

摘要

介绍

尽管儿童感染 SARS-CoV-2 的表现通常较轻或无症状,但感染对儿童麻醉的影响仍然是一个值得关注的问题。有单篇报道表明,感染 SARS-CoV-2 的患者麻醉并发症的风险更高。

材料和方法

我们进行了一项回顾性病例对照研究,分析了 2021 年 4 月 1 日至 9 月 30 日期间,因需要麻醉的紧急手术而入住一家三级儿童医院的 SARS-CoV-2 感染儿童接受全身麻醉的风险。对照组由同一观察期内因相同原因接受全身麻醉的 SARS-CoV-2 阴性儿童组成。我们的假设是:SARS-CoV-2 感染儿童可以安全地进行全身麻醉。研究终点:主要终点-麻醉呼吸系统并发症(支气管痉挛、喉痉挛、术中饱和度低于 94%、苏醒后饱和度低于 94%、计划外术后机械通气);次要终点-住院时间、血栓形成、心脏、出血事件、入住 ICU、住院期间死亡。

结果

检查组包括 58 例 SARS-CoV-2 感染儿童,匹配对照组包括 198 例患者。两组并发症发生率均很低,组间无显著差异。唯一观察到的差异是 SARS-CoV-2 感染患者在苏醒期的饱和度下降频率较高,以及住院时间较长。多变量逻辑回归分析显示,患者的身体状况和手术持续时间是影响并发症风险的主要因素。

结论

根据我们的经验,SARS-CoV-2 感染儿童的麻醉可以安全进行。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b05/10496091/b5dc8f03c192/AIT-55-51313-g001.jpg

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