In Tonsillectomy, Preoperative Albuterol Cuts Risk for Adverse Respiratory Events

By Amy Orciari Herman

Preoperative albuterol helps prevent adverse respiratory events in children undergoing tonsillectomy, according to a JAMA Pediatrics study.

Some 480 children aged 8 years or younger who were undergoing tonsillectomy under general anesthesia were randomized to receive inhaled albuterol or placebo roughly 20 minutes before surgery. Children with cardiopulmonary disease were excluded.

The primary outcome — the incidence of perioperative adverse respiratory events — occurred significantly less often with albuterol than with placebo (28% vs. 48% of children). In particular, the reduction was significant for laryngospasm, coughing, and oxygen desaturation. Adjustment for severity of obstructive sleep apnea (OSA) did not decrease the observed benefits.

The authors estimate that five children would need to receive albuterol to prevent one adverse event. They conclude that “anesthetists should consider the use of albuterol in routine practice, particularly in children with moderate to severe OSA.”