Perioperative Respiratory-Adverse Events Following General Anesthesia Among Pediatric Patients After COVID-19
10.3346/jkms.2023.38.e349
- Author:
Jung-Bin PARK
1
;
Jin Young SOHN
;
Pyoyoon KANG
;
Sang-Hwan JI
;
Eun-Hee KIM
;
Ji-Hyun LEE
;
Jin-Tae KIM
;
Hee-Soo KIM
;
Young-Eun JANG
Author Information
1. Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea
- Publication Type:Original Article
- From:Journal of Korean Medical Science
2023;38(47):e349-
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background:The perianesthetic morbidity, mortality risk and anesthesia-associated risk after preoperative coronavirus disease 2019 (COVID-19) omicron variant in pediatric patients have not been fully demonstrated. We examined the association between preoperative COVID-19 omicron diagnosis and the incidence of overall perioperative adverse events in pediatric patients who received general anesthesia.
Methods:This retrospective study included patients aged < 18 years who received general anesthesia between February 1 and June 10, 2022, in a single tertiary pediatric hospital.They were divided into two groups; patients in a COVID-19 group were matched to patients in a non-COVID-19 group during the omicron-predominant period in Korea. Data on patient characteristics, anesthesia records, post-anesthesia records, COVID-19-related history, symptoms, and mortality were collected. The primary outcomes were the overall perioperative adverse events, including perioperative respiratory adverse events (PRAEs), escalation of care, and mortality.
Results:In total, 992 patients were included in the data analysis (n = 496, COVID-19; n = 496, non-COVID-19) after matching. The overall incidence of perioperative adverse events was significantly higher in the COVID-19 group than in the non-COVID-19 group (odds ratio [OR], 1.92; 95% confidence interval [CI], 1.89–1.94). The difference was significant for PRAEs (OR, 2.00; 95% CI, 1.96–2.02) but not in escalation of care or mortality. The most difference between the two groups was observed in instances of high peak inspiratory pressure ≥ 25 cmH 2 O during the intraoperative period (OR, 11.0; 95% CI, 10.5–11.4). Compared with the non-COVID-19 group, the risk of overall perioperative adverse events was higher in the COVID-19 group diagnosed 0–2 weeks before anesthesia (OR, 6.5; 95% CI, 2.1–20.4) or symptomatic on the anesthesia day (OR, 6.4; 95% CI, 3.30–12.4).
Conclusion:Pediatric patients with the preoperative COVID-19 omicron variant had increased risk of PRAEs. Patients within 2 weeks after COVID-19 or those with symptoms had a higher risk of PRAEs
