Risk factors for airway complications during general anaesthesia in paediatric patients

Background : Although airway complications are a frequent problem during paediatric anaesthesia, no study has prospectively identified risk factors for adverse respiratory events during airway management when LMA(TM) (laryngeal mask airway), face mask (FM) or a tracheal tube (TT) are used. Methods : A prospective study was performed at a university hospital's paediatric centre. Preoperative information included recent history of respiratory infection and type of surgery. Intraoperative information included the identification of the device user, the duration of anaesthesia and the type of airway device used. Adverse respiratory events during the perioperative and postoperative periods were registered. One thousand nine hundred and ninety-six patients were included (mean age 6.45 +/- 2.9 years). Results : Airway complications occurred in 10.2% of the patient for LMA (72/704), 4.7% for FM (19/401) and 7.4% (66/891) for TT. Using a stepwise logistic regression, three independent risk factors were identified: age < 6 years, odds ratio (OR) 1.84, 95% CI (1.21-2.80); use of LMA, OR 2.32, 95% CI (1.29-4.17); presence of respiratory infections (RI) before the procedure, OR 3.72, 95% CI (2.3-5.99). Conclusions : Age < 6 years, recent RI and the use of the LMA were identified as independent factors associated with an increased risk of airway complications.