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Updated: Jun 20, 2026
Methodology for Sputum Induction and Laboratory Processing
Published on: December 17, 2017
Salbutamol premedication in children with a recent respiratory tract infection
Britta S von Ungern-Sternberg1, Walid Habre, Thomas O Erb
1Department of Anesthesia, Princess Margaret Hospital for Children, Perth, WA, Australia. Britta.regli-vonungern@health.wa.gov.au
Insights
Premedication with salbutamol significantly reduced perioperative respiratory adverse events in children with recent respiratory tract infections (RTI). This suggests salbutamol may be beneficial for this patient group.
Area of Science:
- Pediatric Anesthesiology
- Respiratory Medicine
- Pharmacology
Background:
- Beta-2 agonists like salbutamol prevent respiratory resistance and bronchospasm in asthmatic children.
- Children with recent respiratory tract infections (RTI) show bronchial hyperreactivity, leading to increased use of salbutamol for preventing perioperative respiratory adverse events (PRAE).
- A prospective observational study was conducted to evaluate the efficacy of salbutamol premedication in children with RTI.
Purpose of the Study:
- To assess the effectiveness of salbutamol premedication in preventing perioperative respiratory adverse events (PRAE) in children with recent respiratory tract infections (RTI).
Main Methods:
- Analysis of data from 600 children (0-16 years) undergoing general anesthesia.
- Three groups were studied: 200 children with recent RTI receiving salbutamol, 200 with recent RTI not receiving salbutamol, and 200 healthy children without recent RTI.
- Perioperative respiratory adverse events (PRAE) including laryngospasm, bronchospasm, oxygen desaturation, and severe coughing were recorded.
Main Results:
- Children with recent RTI who received salbutamol showed significantly lower rates of perioperative bronchospasm (5.5% vs 11%) and severe coughing (5.5% vs 11.5%) compared to those with RTI who did not receive salbutamol.
- Healthy children had the lowest incidence of respiratory complications (bronchospasm 1.5%, severe coughing 4.5%) regardless of premedication.
- Salbutamol premedication demonstrated a statistically significant benefit in reducing specific PRAE in children with recent RTI.
Conclusions:
- Premedication with salbutamol significantly reduces perioperative respiratory adverse events in children with a recent history of respiratory tract infection compared to no premedication.
- Salbutamol premedication should be considered for children with recent RTI to mitigate risks of perioperative respiratory complications.
- The findings support the routine consideration of salbutamol in pediatric anesthesia for patients with recent RTI.
Background:
Premedication with beta-2 agonists (e.g. salbutamol) is effective in preventing increases in total respiratory resistance and in decreasing the incidence of perioperative bronchospasm in asthmatic children. Because children with recent respiratory tract infection (RTI) exhibit bronchial hyperreactivity similar to that observed in asthmatic children, the use of salbutamol in children with RTI has become popular among pediatric anesthetists for the prevention of perioperative respiratory adverse events (PRAE). In a prospective observational study, we therefore assessed the usefulness of salbutamol premedication on the occurrence of PRAE.
Methods:
Results from 600 children (0-16 years) undergoing general anesthesia were analyzed: 200 children with a recent RTI who received preoperative salbutamol 10-30 min prior to surgery, 200 children with a recent RTI without salbutamol premedication, and 200 children without a RTI during the last 4 weeks. All PRAE (laryngospasm, bronchospasm, oxygen desaturation [<95%], severe coughing) were recorded.
Results:
Children with a recent RTI who received salbutamol demonstrated a significantly reduced incidence of perioperative bronchospasm (5.5% vs 11%, P = 0.0270) and severe coughing (5.5% vs 11.5%, P = 0.0314) compared with children who had an RTI but did not receive salbutamol. However, healthy children presented with the lowest rate (bronchospasm 1.5%, severe coughing 4.5%) of respiratory complications compared with children with a recent RTI independent whether or not they received salbutamol preoperatively.
Conclusions:
The results from this audit suggest that children with a history of a recent RTI have significantly less PRAE following a premedication with salbutamol compared with no premedication. Therefore, premedication with salbutamol might be considered in children with recent RTI.
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