소아마취에서 주술기 호흡기 부작용의 위험 요인; 다기관 연구

Background: Perioperative respiratory adverse events remain a major cause of postoperative morbidity and mortality during pediatric anesthesia. This multicenter study was designed to evaluate the incidence of perioperative respiratory adverse events during elective pediatric surgery and to identify the risk factors for these events. Methods: Pediatric patients undergoing elective surgery under general anesthesia in 11 hospitals were randomly selected for this prospective, multicenter study. Preanesthetic assessments, anesthetic and surgical conditions were recorded by anesthesiologists in charge. Adverse respiratory events were registered. Results: Eight hundred and twenty-three patients were included. The overall incidence of any perioperative respiratory adverse respiratory event was 15.1%. The incidences of perioperative bronchospasm, laryngospasm, coughing, desaturatioin (oxygen saturation ＜95%), and airway obstruction were 0.1, 0.5, 10.2, 4.1,and 1.6% respectively. According to the multivariate analysis, five risk factors were identified: multiple attempts for airway device insertion, odds ratio (OR) 2.88; recent URI (≤2 weeks), OR 1.96;induction with intravenous anesthetics, OR 1.95; airway related surgery, OR 1.88; ASA class ≥2, OR 1.62. Conclusions: Multiple attempts for airway device insertion, recent URI, induction with intravenous anesthetics, airway related surgery and ASA class ≥2 were associated with increased risk for perioperative respiratory adverse events. KCI Citation Count: 3