Airway management process
An otolaryngologist together with an allergist conducted a preoperative
airway evaluation and then established an intervention process for each
child with OSA based on their lung function test (Figure 1 ). In
brief, we screened out patients based on their lung function test for
that general anesthesia with tracheal intubation can elicit
life-threatening bronchospasm in patients with
bronchial
hyperreactivity,
and
increased airway responsiveness is associated with an enhanced risk for
respiratory symptoms and accelerated decline in
FEV1.[18] Therefore, an abnormal FEV1% were
considered as risk factor for airway complications. Patients with a
FEV1% pre value < 80% were given the
atomized drugs at different
frequencies according to the severity of their abnormal lung function.
Atomization inhalation of 1 mg budesonide, 0.25 mg ipratropium, and 2.5
mg terbutaline was given twice a day to mild patients and three times a
day to moderate and moderate-severe patients. The exclusion criterion
for preoperative airway risk was determined based on the patient’s
improvement in lung function after intervention.