Premedication with salbutamol prior to surgery does not decrease the risk of perioperative respiratory adverse events...

Area of Science:

• Anesthesiology
• Pediatric Medicine
• Respiratory Medicine

Background:

• Perioperative respiratory adverse events (PRAE) are a significant cause of morbidity and mortality in children.
• Identifying effective preventative strategies for PRAE in high-risk pediatric patients is crucial.

Purpose of the Study:

• To investigate the efficacy of inhaled salbutamol premedication in reducing PRAE in children at high risk.
• To assess the impact of salbutamol on specific events like bronchospasm, laryngospasm, airway obstruction, desaturation, coughing, and stridor.

Main Methods:

• A double-blinded, randomized controlled trial was conducted involving children aged 6-16 years with at least two risk factors for PRAE.
• Participants were randomized to receive either 200 µg of inhaled salbutamol or a placebo before elective surgery.
• Perioperative respiratory adverse events were systematically recorded and analyzed.

Main Results:

• A total of 462 children were included in the intention-to-treat analysis.
• The incidence of PRAE was 14% in the placebo group and 12% in the salbutamol group, a difference that was not statistically significant (OR: 0.83, P=0.51).
• Specific events like oxygen desaturation and severe coughing did not significantly differ between the groups.

Conclusions:

• Premedication with inhaled salbutamol did not significantly reduce the risk of PRAE in children aged 6-16 years undergoing surgery.
• The study did not find evidence to support the use of salbutamol for preventing perioperative respiratory complications in this high-risk pediatric group.