Yu Shenghua, Xu Cheng, Yao Jun, Cai Jingjie, Wei Rong, Jiang Yan
Department of Anesthesiology, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200062, China.
Department of Anaesthesiology, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, 600 Yishan Road, Shanghai, China.
Ital J Pediatr. 2025 May 19;51(1):146. doi: 10.1186/s13052-025-02013-8.
Upper respiratory tract infections (URTIs) and perioperative respiratory adverse events (PRAEs) pose significant risks for anesthesia in children undergoing tonsillectomy. This study aimed to determine whether URTIs is associated with PRAEs during postanesthesia recovery after tonsillectomy.
Children underwent tonsillectomy, with or without adenoidectomy at Shanghai Children's Hospital from 1 October 2022 to 30 July 2023. We assessed associations between URTIs and PRAEs during postanesthesia recovery in pediatric patients. In total, 94 patients with URTIs were propensity score-matched 1:1 with 94 patients without URTIs. The study's main outcome measure was the difference in PRAEs incidence between the two groups.
Children with URTIs were more likely to experience PRAEs than those without URTIs (68 of 94 [72.3%] vs. 25 of 94 [26.6%]; odds ratio [OR], 7.44; 95% CI, 3.34-17.38). They were also more likely to require interventional management post-PRAEs in the post-anesthesia care unit, such as jaw support (OR, 5.01; 95% CI, 2.06-12.20) and mask-assisted oxygenation (OR, 7.85; 95% CI, 3.98-15.50), but no other serious clinical adverse events were observed.
Children with URTIs had an increased incidence of PRAEs, but only minor interventions were needed to relieve symptoms without serious adverse events. Most children can be safely anesthetized even with URTIs if perioperative anesthesia management is optimized.
The study protocol was registered with the Chinese Clinical Trial Registry (registration number: ChiCTR2400084682) on 22 May 2024. https://www.chictr.org.cn/showproj.html?proj=230630 .
上呼吸道感染（URTIs）和围手术期呼吸道不良事件（PRAEs）给接受扁桃体切除术的儿童麻醉带来重大风险。本研究旨在确定扁桃体切除术后麻醉恢复期间URTIs是否与PRAEs相关。
2022年10月1日至2023年7月30日期间，在上海儿童医学中心接受扁桃体切除术（有或无腺样体切除术）的儿童。我们评估了儿科患者麻醉恢复期间URTIs与PRAEs之间的关联。总共94例患有URTIs的患者与94例未患有URTIs的患者进行1:1倾向评分匹配。该研究的主要结局指标是两组之间PRAEs发生率的差异。
患有URTIs的儿童比未患有URTIs的儿童更有可能发生PRAEs（94例中的68例[72.3%] vs. 94例中的25例[26.6%]；优势比[OR]，7.44；95%置信区间[CI]，3.34 - 17.38）。他们在麻醉后护理单元发生PRAEs后也更有可能需要介入管理，如下颌支撑（OR，5.01；95% CI，2.06 - 12.20）和面罩辅助给氧（OR，7.85；95% CI，3.98 - 15.50），但未观察到其他严重临床不良事件。
患有URTIs的儿童PRAEs发生率增加，但仅需进行小的干预来缓解症状，无严重不良事件。如果围手术期麻醉管理得到优化，即使患有URTIs，大多数儿童也可安全麻醉。
该研究方案于2024年5月22日在中国临床试验注册中心注册（注册号：ChiCTR2400084682）。https://www.chictr.org.cn/showproj.html?proj=230630 。
