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Published on: July 14, 2023
Adverse Events in Children Receiving General Anaesthesia with Laryngeal Mask Airway Insertion
S Khatiwada1, B Bhattarai1, K Pokharel1
1Department of Anesthesiology and Critical Care, BPKIHS, Dharan, Nepal.
Insights
Pediatric perioperative adverse events, primarily respiratory, are common, especially after laryngeal mask airway removal. Events differ by age, with younger children experiencing more respiratory issues and older children more cardiac events.
Area of Science:
- Anesthesiology
- Pediatric Surgery
- Patient Safety
Background:
- Perioperative adverse events are more frequent in pediatric patients than adults.
- Adverse event reporting is crucial for problem identification, prevention, and management.
- Understanding pediatric perioperative events aids in improving patient outcomes.
Purpose of the Study:
- To identify the types and incidence of perioperative adverse events in children.
- To determine the timing of these adverse events.
- To compare adverse event occurrence between children under and over five years old.
Main Methods:
- Prospective study of 242 pediatric patients (1 day to 14 years).
- Patients received general anesthesia with a laryngeal mask airway for elective surgeries.
- Adverse events during the perioperative period were systematically recorded.
Main Results:
- Respiratory events (55%) were the most common adverse events, followed by cardiovascular events (30%).
- Adverse events occurred in 10% of patients in the operating room and 8% in the post-anesthesia care unit.
- Respiratory events were more frequent in children under five (p=0.007), while cardiac events were more frequent in those over five (p=0.02).
Conclusions:
- The most frequent adverse event in pediatric patients is respiratory in nature.
- Adverse events are more common in the operating room, particularly after laryngeal mask airway removal.
- Age-related differences exist, with younger children experiencing more respiratory events and older children more cardiac events.
Introduction:
Perioperative adverse events are more common in children compared to adult population. Reporting an adverse event proves effective in identifying problems and helps in prevention and early management. Our objective was to identify the types, incidence, and the time of occurrence of perioperative adverse event. We also aimed to find out whether the occurrence of the types of adverse events differ in children below and above five years.
Methods:
This was a prospective study in 242, ASA Physical Status I and II children aged day one to 14 years, receiving general anesthesia with laryngeal mask airway for various elective surgeries. Adverse events observed in the perioperative period were recorded.
Results:
Adverse events related to respiratory system (n=26, 55%) were the most common followed by cardiovascular system (n= 14, 30%). Adverse events were observed in 24(10%) children in the operating room and in 20 (8%) children in the post anaesthesia care unit. In the operating room, majority (14 of 27, 52%) of the events occurred immediately after removal of laryngeal mask airway. Respiratory events were more common in children below five years (p=0.007), whereas cardiac events were more common in children above five years (p=0.02).
Conclusions:
The commonest adverse event in children is related to respiratory system. Adverse events occur more frequently in the operating room, mostly immediately after removal of laryngeal mask airway. Respiratory events are more frequent in children below five years whereas cardiac events are more frequent in children above five years.
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