Association of upper respiratory tract infection with perioperative respiratory adverse events in pediatric tonsillectomy patients

Abstract Background 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 to...

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Main Authors: Shenghua Yu, Cheng Xu, Jun Yao, Jingjie Cai, Rong Wei, Yan Jiang
Format: Article
Language:English
Published: BMC 2025-05-01
Series:Italian Journal of Pediatrics
Subjects:
Online Access:https://doi.org/10.1186/s13052-025-02013-8
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author Shenghua Yu
Cheng Xu
Jun Yao
Jingjie Cai
Rong Wei
Yan Jiang
author_facet Shenghua Yu
Cheng Xu
Jun Yao
Jingjie Cai
Rong Wei
Yan Jiang
author_sort Shenghua Yu
collection DOAJ
description Abstract Background 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. Methods 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. Results 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. Conclusions 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. Trial registration 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 .
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spelling doaj-art-ccd0a378f473484fbf7546f46bd5f4c52025-08-20T02:29:26ZengBMCItalian Journal of Pediatrics1824-72882025-05-015111910.1186/s13052-025-02013-8Association of upper respiratory tract infection with perioperative respiratory adverse events in pediatric tonsillectomy patientsShenghua Yu0Cheng Xu1Jun Yao2Jingjie Cai3Rong Wei4Yan Jiang5Department of Anesthesiology, Shanghai Children’s Hospital, School of Medicine, Shanghai Jiao Tong UniversityDepartment of Anaesthesiology, Shanghai Sixth People’s Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Anaesthesiology, Shanghai Sixth People’s Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Anesthesiology, Shanghai Children’s Hospital, School of Medicine, Shanghai Jiao Tong UniversityDepartment of Anesthesiology, Shanghai Children’s Hospital, School of Medicine, Shanghai Jiao Tong UniversityDepartment of Anesthesiology, Shanghai Children’s Hospital, School of Medicine, Shanghai Jiao Tong UniversityAbstract Background 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. Methods 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. Results 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. Conclusions 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. Trial registration 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 .https://doi.org/10.1186/s13052-025-02013-8Paediatric anaesthesiaRespiratory adverse eventsUpper respiratory tract infectionTonsillectomyGeneral anesthesia
spellingShingle Shenghua Yu
Cheng Xu
Jun Yao
Jingjie Cai
Rong Wei
Yan Jiang
Association of upper respiratory tract infection with perioperative respiratory adverse events in pediatric tonsillectomy patients
Italian Journal of Pediatrics
Paediatric anaesthesia
Respiratory adverse events
Upper respiratory tract infection
Tonsillectomy
General anesthesia
title Association of upper respiratory tract infection with perioperative respiratory adverse events in pediatric tonsillectomy patients
title_full Association of upper respiratory tract infection with perioperative respiratory adverse events in pediatric tonsillectomy patients
title_fullStr Association of upper respiratory tract infection with perioperative respiratory adverse events in pediatric tonsillectomy patients
title_full_unstemmed Association of upper respiratory tract infection with perioperative respiratory adverse events in pediatric tonsillectomy patients
title_short Association of upper respiratory tract infection with perioperative respiratory adverse events in pediatric tonsillectomy patients
title_sort association of upper respiratory tract infection with perioperative respiratory adverse events in pediatric tonsillectomy patients
topic Paediatric anaesthesia
Respiratory adverse events
Upper respiratory tract infection
Tonsillectomy
General anesthesia
url https://doi.org/10.1186/s13052-025-02013-8
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