Abstract
Background: Perioperative cardiac and respiratory adverse events remain major pediatric morbidity and mortality especially for children less than 1 year old. Physical status, anesthetic management and surgical profile are three main facets of perioperative setting and need to be investigated to identify useful predictors for perioperative adverse events in this population of fragile infants.
Methods: In this retrospective cohort study, all infants undergoing general anesthesia for ophthalmological surgeries at Peking University People’s Hospital, Beijing, China from November 1, 2016 to October 31, 2017. Physical status, anesthesia and surgical management were analyzed by exploratory factor analysis and component matrix to explore risk factors for bradycardia and postoperative desaturation, the most commonly seen pediatric anesthesia related adverse events.
Results: After the 12 months, 350 cases were included, among whom 71 infants underwent two surgeries required by their ophthalmological conditions. The median post conceptual age at the time of surgery was 50 (42, 63) weeks. Bradycardia (31/350, 8.9%) and postoperative desaturation (36/350, 10.3%) were identified as major cardiac and respiratory adverse events. Preoperative Atropine, intubation and bigger body weight would prevent patients suffering from bradycardia, while longer duration of anesthesia was a risk factor for bradycardia. Low body weight was also a risk factor for postoperative desaturation. Body weight cut-off point identified was 3.15kg, which meant that, infants who were lighter than 3.15 kg, the chance of postoperative desaturation was significantly higher than who are heavier than 3.15kg (27.8% vs 4.2%, P=0.000).
Conclusion: This study found that longer duration of anesthesia was related with a higher incidence of bradycardia and low body weight is a predictor for postoperative desaturation.
Funding: This study was supported by Research and Development Grant of Peking University People's Hospital, RDC2012-12.
Keywords: Pediatric, respiratory depression, premature babies with retinopathy.
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