The Incidence of Perioperative Adverse Events in Neonates and Infants Undergoing Non Cardiac Surgery with General Anesthesia
Sahatsa Mandee MD*, Thanaporn Jitpakdee MD*, Tarinee Bausuk BNS*, Naiyana Aroonpruksakul MD*
Affiliation : * Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Objective : To report the incidence of, and to identify the risk factors for, perioperative adverse events in neonates and infants
when undergoing general anesthesia.
Material and Method: A prospective observational study approved by an institutional ethics committee was conducted at a
tertiary care university hospital. The inclusion criteria were neonates and infants who had undergone general anesthesia for
non-cardiac surgery. Data on the patients’ demographics, their preoperative abnormalities, and the potential risk factors for
adverse events were collected. Details of all adverse events occurring from the induction of anesthesia till 24-hours
postoperatively were recorded.
Results : A total of 130 neonates and infants were recruited for this study. The overall incidence of adverse events was 33.6%.
The most common events were insufficient ventilation arising from endotracheal tube leakage (15.4%), followed by multiple-
attempt endotracheal intubation (14.6%). Desaturation ranked third, being reported in 11.5% of the population. Bradycardia
was the most common cardiovascular event (6.9%), with 50% of the affected patients requiring atropine administration.
Cardiac arrest was reported in a neonate with complex heart disease (0.8%). Based on a multivariate logistic analysis, an
increased risk for perioperative adverse events was associated with a body weight less than 2,500 grams (OR 3.32, 95% CI
1.17 to 9.45); an American Society of Anesthesiologists (ASA) Physical Status greater or equal to II (OR 25.5, 95% CI 3.35
to 194); cardiovascular comorbidity (OR 3.6, 95% CI 1.59 to 8.14), and respiratory comorbidity (OR 2.2, 95% CI 1.01 to
4.9).
Conclusion : Our study confirms that neonates and infants had a high risk of developing perioperative adverse events, with
respiratory problems being the most common. A low body weight, an ASA >II, and respiratory andcardiovascular comorbidities
increased the risk for perioperative adverse events.
Keywords : Adverse event, Infants, Neonates, Anesthesia
