Case 3: Strabismus Surgery

Question 1

What are the risks of proceeding with a case when a child has upper respiratory tract infection?

How long would you delay a case?

Answer 1

Patients w/ acute or recent respiratory tract infection are at increased risk of perioperative respiratory complications such as

1. Laryngospasm
2. Bronchospasm
3. Oxygen desaturation

Risk is even greater in patients w/ severe symptoms such as fever, productive cough, mucoid secretions, malaise, and have additional risk factors

Delay case for 4-6 weeks following resolution of current respiratory infection, to allow significant reduction in airway hyperreactivity

Question 2

Can you give atromine to optimize asthmatic condition?

Answer 2

Can consider administering atropine, recognizing that it may help prevent complications associated w/ recent URI, asthma, and Oculocardiac reflex

Anticholinergic may be beneficial for asthmatic patients 2/2 reduced mucous gland secrertions and airway hyperreactivity.