The common cold and anesthesia
Help children facing surgery avoid complications
The cold season typically runs from September through March, making it a challenge for young children to be healthy for surgery six months out of the year.
Children younger than six years old have an average of 6 to 10 colds per year. Most colds are caused by viruses that the immune system fights and rids the body of in approximately two weeks. However, lingering effects of a cold including airway swelling and irritation may last for up to six weeks.
Because no two colds or children are alike, the impact of their illness on a general anesthetic will vary. For some children with a cold, undergoing general anesthesia will enhance the current symptoms – e.g., a runny nose may be runnier, a cough more pronounced – for a short period after the anesthetic. For other children with a cold, they may have trouble breathing and require hospitalization after the procedure.
Most children do not have any long-term complications from having general anesthesia during a cold. However, there are some instances where the anesthesiologist may consider general anesthesia to be too risky based on the severity of your child’s cold. Usually a child’s cold symptoms are worst at the beginning of the cold, when they may have thick secretions from the nose or mouth, productive cough, fever greater than 100.4°F, low energy and loss of appetite. This is the time when a child is most at risk for having breathing complications while under general anesthesia.
There are other considerations an anesthesiologist may look for when assessing the safety of providing anesthesia to a child with a cold. Physical exam findings of abnormal chest movement, wheezing or congestion when listening to a child’s lungs are signs of a more severe cold. In addition, the type of surgery, urgency of the surgery, a child’s other medical conditions, passive smoke exposure and the child’s age will be considered by an anesthesiologist.
There are some precautions an anesthesiologist may take to reduce the risk of a breathing complications in a child with a cold. The placement of an oxygen sticker prior to having a child go off to sleep will help alert the anesthesiologist to early breathing complications. In addition, placement of a laryngeal mask airway instead of a breathing tube may reduce the risk of breathing complications.
Most children with a runny nose and a cough will be safe under general anesthesia and will proceed with their scheduled surgery. If the anesthesiologist is concerned about your child’s safety, canceling your child’s procedure for at least four weeks will ensure the safest circumstances for your child to undergo general anesthesia.
Cold season can be a struggle for families with children who experience multiple infections. Keeping your child safe while undergoing a surgical procedure is of utmost concern. If you have any questions prior to your surgery, call your surgeon or anesthesiologist before going to the hospital.
Rebecca Evans is an anesthesiologist at the Children’s Hospital at Dartmouth-Hitchcock and assistant professor of pediatric anesthesiology at The Geisel School of Medicine at Dartmouth. For more information on pediatric anesthesia services at the Children’s Hospital at Dartmouth-Hitchcock, go to www.chadkids.org.