Lakshmipathy N, Bokesch P M, Cowen D E, Lisman S R, Schmid C H
Department of Anesthesiology, Tufts University School of Medicine, New England Medical Center, Boston, Massachusetts, USA.
Anesth Analg. 1996 Apr;82(4):724-7. doi: 10.1097/00000539-199604000-00008.
Adult patients who smoke are known to have airway complications during general anesthesia. The objective of this study was to explore the relationship between environmental tobacco smoke (ETS) exposure in the home and laryngospasm during general anesthesia in pediatric patients. A retrospective, cohort study was performed on pediatric ambulatory patients in the day surgery center and main operating room of a university hospital. We studied 310 consecutive pediatric patients (all ASA physical status I) who underwent an outpatient elective ear, nose, and throat or urologic surgical procedure in the spring and summer of 1994, and received inhalation induction by mask with halothane. Laryngospasm was identified from quality management and anesthetic records, and included only those patients whose records indicated that succinylcholine was given because of oxygen desaturation and inability to ventilate. Patients' families were questioned within 1 wk after surgery as to the number of smokers in each child's household. Of 96 children with ETS exposure, 9 (9.4%) developed laryngospasm. Of the 214 patients without domestic ETS exposure, 2 (0.9%) developed laryngospasm. The relative risk for developing laryngospasm was 10 times higher in the ETS-exposed patients compared with the non-ETS-exposed group (95% confidence interval = 2.2-45.6; P < 0.001). We conclude that ETS exposure is a strong risk factor for laryngospasm in infants and children during general anesthesia.
众所周知，成年吸烟者在全身麻醉期间会出现气道并发症。本研究的目的是探讨小儿患者家庭环境烟草烟雾（ETS）暴露与全身麻醉期间喉痉挛之间的关系。对一家大学医院日间手术中心和主手术室的小儿门诊患者进行了一项回顾性队列研究。我们研究了1994年春夏季连续接受门诊择期耳鼻喉或泌尿外科手术并通过面罩吸入氟烷进行诱导麻醉的310例小儿患者（均为ASA身体状况I级）。从质量管理和麻醉记录中识别喉痉挛，仅包括那些记录显示因氧饱和度下降和无法通气而给予琥珀酰胆碱的患者。在术后1周内询问患者家属每个孩子家庭中的吸烟者数量。在96例有ETS暴露的儿童中，9例（9.4%）发生了喉痉挛。在214例无家庭ETS暴露的患者中，2例（0.9%）发生了喉痉挛。与无ETS暴露组相比，有ETS暴露的患者发生喉痉挛的相对风险高10倍（95%置信区间=2.2-45.6；P<0.001）。我们得出结论：ETS暴露是婴幼儿在全身麻醉期间发生喉痉挛的一个重要危险因素。
