Upper Respiratory Infection

The child with an upper respiratory tract infection presenting for surgery is probably the most common dilemma that faces the pediatric anesthesiologist. While cancellation of such a child’s operation had been a common practice in the past, nowadays, an anesthesiologist will more than likely proceed with the anesthetic management of a child with a mild common cold. Research has shown that while perioperative respiratory adverse events are likely to occur in a child with a mild cold, these events are very easily managed. In addition, the use of a laryngeal mask airway which prevents instrumentation of a child’s airway drastically decreases the incidence of perioperative adverse events in this patient population. Planned airway surgery, history of prematurity, reactive airway disease, and passive smoking in the home are factors that increase the incidence of perioperative adverse respiratory events in a child with an active cold.