Objective: Determine if passive smoke exposure (PSE) increases airway complications during outpatient mask anesthesia procedures in children. Methods: A prospective cohort of children who underwent surgical procedures under mask anesthesia was studied with the American Thoracic Society children's questionnaire on environmental and respiratory factors. Double-blinded outcomes with respect to adverse airway events were recorded both intraoperatively and in the recovery room for patients with and without passive smoke exposure. Multivariate comparisons assessing the likelihood of these airway complications were conducted between the PSE and nonexposed groups. Results: Of 405 children, 168 (41.5%) had PSE. The incidence of airway complications during anesthesia or postanesthetic recovery was higher for all outcome measures for PSE children (all P ≤ 0.005), except for recovery room breath holding (P = 0.086). Intraoperative laryngospasm and airway obstruction were 4.9 and 2.8 times more likely with PSE, respectively. Conclusions: PSE significantly increases the risk of anesthesia-related airway complications during outpatient pediatric procedures. EBM rating: A-1b.
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