DO CHILDREN WHO EXPERIENCE LARYNGOSPASM HAVE AN INCREASED RISK OF UPPER RESPIRATORY-TRACT INFECTION

Background Laryngospasm is the most frequently reported respiratory co mplication associated with upper respiratory infection and general ane sthesia in retrospective studies, but prospective studies have failed to demonstrate any increase in risk. Methods: A case-control study was performed to examine whether children with laryngospasm mere more lik ely to have an upper respiratory infection on the day of surgery. The parents of all patients (N = 15,183) who mere admitted through the day surgery unit were asked if their child had an active or recent (withi n 2 weeks of surgery) upper respiratory infection and were questioned about specific signs and symptoms to determine if the child met Tait a nd Knight's definition of an upper respiratory infection. Control subj ects were randomly selected from patients whose surgery had occurred w ithin 1 day of the laryngospasm event. Results: Patients who developed laryngospasm (N = 123) mere 2.05 times (95% confidence interval 1.21- 3.45) more likely to have an active upper respiratory infection as def ined by their parents than the 492 patients in the control group (P le ss than or equal to 0.01). The development of laryngospasm was not rel ated to Tait and Knight's definition for an upper respiratory infectio n or to recent upper respiratory infection. Children with laryngospasm were more likely to be younger (odds ratio = 0.92, 95% confidence int erval 0.87-0.99), to be scheduled for airway surgery (odds ratio = 2.0 8, 95% confidence Interval 1.21-3.59), and to have their anesthesia su pervised by a less experienced anesthesiologist (odds ratio = 1.69, 95 % confidence interval 1.04-2.7) than children in the control group. Co nclusion: Laryngospasm was more likely to occur in children with an ac tive upper respiratory infection, children who were younger, children who were undergoing airway surgery, and children whose anesthesia were supervised by less experienced anesthesiologists. Understanding the r isk factors and the magnitude of the likely risk should help clinician s make the decision as to whether to anesthetize children with upper r espiratory infection.