Main Article Content

Abstract

BACKGROUND


A recent upper respiratory tract infection is linked to the development of peri-operative respiratory complications. In this study we wanted to evaluate the effect of salbutamol premedication on the incidence of peri-operative respiratory adverse events in children with a recent upper respiratory tract infection (PRAE).


METHODS


A randomized clinical trial study that was conducted at the Children Welfare Teaching Hospital for a period of six months. It included 90 children aged ≤ 16 years who underwent a surgical operation under general anesthesia with a laryngeal mask airway or a tracheal tube and were divided into three groups; (had a recent URTI and received preoperative salbutamol, those who had a recent URTI and didn’t receive preoperative salbutamol, and those with no URTI group). The preferred outcome was the difference in the rate of occurrence of PRAE between children who had received salbutamol and those who hadn’t.


RESULTS


Four children with no URTI (13.3%) developed peri-operative respiratory adverse events. The incidence of bronchospasm and severe cough was significantly higher in patients with URTI and who didn’t receive preoperative salbutamol than in those with URTI who received preoperative salbutamol.


CONCLUSIONS


Preoperative salbutamol doses 10 – 30 minutes before surgery have been demonstrated to reduce and treat peri-operative respiratory adverse events.

Keywords

Salbutamol, URTI, PRAE, Premedication, Anesthesia, Iraq.

Article Details

How to Cite
Mustafa Mohammed Salih, & Hussein Talib Mohsin. (2023). Effect of Nebulized Salbutamol Premedication on Perioperative Respiratory Adverse Events in Children with Recent Respiratory Tract Infections. Journal of Evolution of Medical and Dental Sciences, 12(4), 112–115. https://doi.org/10.14260/jemds.v12i4.388

References

  1. Regli A, Becke K, von Ungern-Sternberg BS. An update on the perioperative management of children with upper respiratory tract infections. Curr Opin Anesthesiol 2017;30(3):362-7.
  2. Lee HJ, Woo JH, Cho S, et al. Risk factors for perioperative respiratory adverse events in children with recent upper respiratory tract infection: a single-center-based retrospective study. Ther Clin Risk Manag 2020;16:1227-34.
  3. Zhang S, Zhang R, Cai M, et al. Intranasal dexmedetomidine premedication in children with recent upper respiratory tract infection undergoing interventional cardiac catheterisation: a randomised controlled trial. Eur J Anaesthesiol 2020;37(2):85-90.
  4. von Ungern-Sternberg BS, Boda K, Chambers NA, et al. Risk assessment for respiratory complications in paediatric anaesthesia: a prospective cohort study. Lancet 2010;376(9743):773-83.
  5. Ramgolam A, Hall G, Zhang G, et al. Prediction of peri‐operative adverse respiratory events in children: the role of exhaled nitric oxide. Anaesthesia 2015;70(10):1160-4.
  6. Oofuvong M, Geater AF, Chongsuvivatwong V, et al. Excess costs and length of hospital stay attributable to perioperative respiratory events in children. Anesth Analg 2015;120(2):411-9.
  7. Morray JP. Cardiac arrest in anesthetized children: recent advances and challenges for the future. Pediatr Anaesth 2011;21(7):722-9.
  8. Murat I, Constant I, Maudhuy H. Perioperative anaesthetic morbidity in children: a database of 24 165 anaesthetics over a 30‐month period. Pediatr Anaesth 2004;14(2):158-66.
  9. von Ungern-Sternberg BS, Saudan S, Petak F, et al. Desflurane but not sevoflurane impairs airway and respiratory tissue mechanics in children with susceptible airways. Anesthesiology 2008;108(2):216-24.
  10. Ramgolam A, Hall G, Sommerfield D, et al. Premedication with salbutamol prior to surgery does not decrease the risk of perioperative respiratory adverse events in school-aged children. Br J Anaesth 2017;119(1):150-7.
  11. Drake-Brockman TF, Ramgolam A, Zhang G, et al. The effect of endotracheal tubes versus laryngeal mask airways on perioperative respiratory adverse events in infants: a randomised controlled trial. Lancet 2017;389(10070):701-8.
  12. Michel F, Vacher T, Julien-Marsollier F, et al. Peri-operative respiratory adverse events in children with upper respiratory tract infections allowed to proceed with anaesthesia: a French national cohort study. Eur J Anaesthesiol 2018;35(12):919-28.
  13. von Ungern-Sternberg BS, Boda K, Schwab C, et al. Laryngeal mask airway is associated with an increased incidence of adverse respiratory events in children with recent upper respiratory tract infections. Anesthesiology 2007;107(5):714-9.
  14. Lema GF, Berhe YW, Gebrezgi AH, et al. Evidence-based perioperative management of a child with upper respiratory tract infections (URTIs) undergoing elective surgery; a systematic review. Int J Surg Open 2018;12:17-24.
  15. Flick RP, Wilder RT, Pieper SF, et al. Risk factors for laryngospasm in children during general anesthesia. Pediatr Anesth 2008;18(4):289-96.
  16. Joos G, O'connor B. Indirect airway challenges. Eur Respir J 2003;21(6):1050-68.
  17. Von Ungern‐Sternberg BS, Habre W, Erb TO, et al. Salbutamol premedication in children with a recent respiratory tract infection. Pediatr Anaesth 2009;19(11):1064-9.
  18. Scalfaro P, Sly PD, Sims C, et al. Salbutamol prevents the increase of respiratory resistance caused by tracheal intubation during sevoflurane anesthesia in asthmatic children. Anaesth Analg 2001;93(4):898-902.
  19. Elwood T, Morris W, Martin LD, et al. Bronchodilator premedication does not decrease respiratory adverse events in pediatric general anesthesia. Can J Anaesth 2003;50(3):277.