CHILDREN with a dry night cough, eczema or who wheeze with exercise have more than eight times the risk of asthma attack under anaesthetic.
The situation can be fatal if corrective drugs fail.
The same factors put affected children at four times the risk that their vocal cords will lock up while under sedation, a situation that requires the prompt use of muscle-relaxing drugs to allow air back into the lungs.
The findings – the result of Australian research involving nearly 10,000 children undergoing operations at a Perth hospital – suggest doctors can more accurately predict which children are at highest risk for bad reactions by asking whether they share these risk factors.
The research also indicates that a child who has recently had a cold or another airway infection is at increased risk for an anaesthetic reaction for only two weeks afterwards – the first time doctors have had a clear idea of how long the post-infectious danger period lasts.
Serious adverse events are extremely rare among children under anaesthetic.
The research, published yesterday in the British medical journal The Lancet, showed that 1392, or 15 per cent, of the 9297 children for whom full data was available had respiratory adverse events during or soon after their operations.
However, pediatric anaesthetist Britta von Ungern-Sternberg, who ran the study at Perth’s Princess Margaret Hospital for Children, said most of these events were minor and transient, and only a tiny sub-group experienced lasting harm.
“It’s pinpointed the risk factors – how we can predict the children who are going to have complications,” she said.
Andrew Davidson, staff anaesthetist at the Royal Children’s Hospital in Melbourne, said it was “a significant study because it has really crystallised a lot of the previous ‘maybes’ about which children are likely to get complications”.
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