The Effect of General Anesthesia on Upper Respiratory Tract Infections in Children (Viruses).

Abstract

The presence of an acute upper respiratory tract infection (URI) in a patient presenting for elective surgery has always been considered a contra-indication to anesthesia. As a result, elective procedures are generally postponed until the patient is asymptomatic; a delay which may be as long as 4 - 6 weeks. Such delays may be inconvenient and costly, and are undoubtedly psychologically unsettling for the patient. The practice of rescheduling patients with URIs is the result of a belief among many anesthesiologists that respiratory tract infections are exacerbated by general anesthesia and /or that the potential for intra- and postoperative complications is enhanced. This thesis encompasses two related fields of endeavor. The first phase examines the effect of general anesthesia on the development of intra- and postoperative respiratory complications in children with acute uncomplicated upper respiratory tract infections. The second phase examines the effect of general anesthesia on the natural history of URIs in terms of symptom prevalence and duration. In addition, the contribution of a number of demographic variables to the presence of acute and chronic respiratory illness was evaluated. Variables of interest include sex, age, socioeconomic status, parental smoking and parental history of respiratory illness. A cost analysis was also undertaken to evaluate the potential financial implications of rescheduling surgery. The population under study consisted of 489 children between the ages of 1 and 12 years, with a history of acute recurrent of chronic otitis media that required surgery for myringotomy and tympanostomy tube placement. Response variables were obtained using st and ardized questionnaires and medical records. The results of this study suggest that there is no increased intra- and postoperative morbidity for children presenting at minor surgery with uncomplicated URIs, and postponement of elective procedures for this reason may be unnecessary. In addition, the administration of general anesthesia to a patient with an acute uncomplicated URI was shown to decrease both the appearance and duration of a number of respiratory symptoms, a finding that may allow the physician to better underst and and predict the outcome of anesthesia administered to an infected individual.