• Br J Anaesth · Nov 2022

    Clinical Trial

    Neonates undergoing pyloric stenosis repair are at increased risk of difficult airway management: secondary analysis of the NEonate and Children audiT of Anaesthesia pRactice IN Europe.

    • Nicola Disma, Thomas Engelhardt, Tom G Hansen, Jurgen C de Graaff, Katalin Virag, Walid Habre, NECTARINE Group of the European Society of Anaesthesiology and Intensive, AUSTRIA (Maria Vittinghoff), BELGIUM (Francis Veyckemans), CROATIA (Sandra Kralik), CZECH REPUBLIC (Jiří Žurek), DENMARK (Tom Hansen), ESTONIA (Reet Kikas), FINLAND (Tuula Manner), FRANCE (Christophe Dadure, Anne Lafargue), GERMANY (Karin Becke, Claudia Hoehne), GREECE (Anna Malisiova), HUNGARY (Andrea Székely), IRELAND (Brendan O’Hare), ITALY (Nicola Disma), LATVIA (Zane Straume), LITHUANIA (Laura Lukosiene), LUXEMBOURG (Bernd Schmitz), MALTA (Francis Borg), NETHERLANDS (Jurgen de Graaff), NORWAY (Wenche B Boerke), POLAND (Marzena Zielinska), PORTUGAL (Maria Domingas Patuleia), ROMANIA (Radu Tabacaru), SERBIA (Dusica Simic), SLOVAKIA (Miloslav Hanula), SLOVENIA (Jelena Berger), SPAIN (Ignacio Gálvez Escalera), SWEDEN (Albert Castellheim), SWITZERLAND (Walid Habre), TURKEY (Dilek Özcengiz - Zehra Hatipoğlu), UKRAINE (Dmytro Dmytriiev), UNITED KINGDOM (Thomas Engelhardt, Suellen Walker), and Management Team.
    • Unit for Research and Innovation, Department of Anaesthesia, IRCCS Istituto Giannina Gaslini, Genova, Italy. Electronic address: nicoladisma@icloud.com.
    • Br J Anaesth. 2022 Nov 1; 129 (5): 734739734-739.

    BackgroundHypertrophic pyloric stenosis in otherwise healthy neonates frequently requires urgent surgical procedure but anaesthesia care may result in respiratory complications, such as hypoxaemia, pulmonary aspiration of gastric contents, and postoperative apnoea. The primary aim was to study whether or not the incidence of difficult airway management and of hypoxaemia in neonates undergoing pyloric stenosis repair was higher than that in neonates undergoing other surgeries.MethodsData on neonates and infants undergoing anaesthesia and surgery for pyloric stenosis were extracted from the NEonate and Children audiT of Anesthesia pRactice In Europe (NECTARINE) database, for secondary analysis.ResultsWe identified 310 infants who had anaesthesia for surgery for pyloric stenosis. Difficult airway management (more than two attempts at laryngoscopy) was higher in children with pyloric stenosis when compared with the entire NECTARINE cohort (7.9% [95% confidence interval {CI}, 5.22-11.53] vs 4.4% [95% CI, 1.99-6.58]; relative risk [RR]=1.81 [95% CI, 1.21-2.69]; P=0.004), whereas transient hypoxaemia with oxygen saturation <90% was comparable between the two cohorts. Postoperative complications occurred in 16 children (5.6%) within the 30-day follow-up. No mortality was reported at 30 and 90 days.ConclusionsChildren undergoing surgery for pyloric stenosis had a higher incidence of difficult intubation compared with the entire NECTARINE cohort.Clinical Trial RegistrationNCT02350348.Copyright © 2022 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.

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