This review summarises the current evidence for the perioperative preparation in children with upper respiratory tract infections (URTI), including COVID-19 infection. URTI, including COVID-19 infection, are common and frequent in children who present for elective surgery. Children with URTI are at increased risk of perioperative respiratory adverse events. Perioperative respiratory adverse events are among the most serious and impactful consequences of paediatric anaesthesia, including cardiorespiratory arrest, and therefore present a significant challenge for the paediatric anaesthetist. This review addresses the pathophysiology and time course of URTI, including COVID-19. The evidence-based patient, anaesthetic, and surgical risk factors for perioperative respiratory adverse events are summarised. These risk factors work synergistically to determine individual patient risk and allow for risk stratification both clinically and with validated scoring systems. Evidence-based optimisation of modifiable respiratory risk factors can reduce the risk of perioperative bronchospasm. The evidence for the anaesthesia management options, including the timing and setting of surgery, experience of the paediatric anaesthetist, premedication, choice of airway device, choice of agent for induction and maintenance of anaesthesia, and deep vs awake tracheal extubation techniques along with a risk stratification framework are discussed.

中文翻译：

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儿童上呼吸道感染的术前准备：重点叙述性回顾。


本综述总结了上呼吸道感染 （URTI） 儿童围手术期准备（包括 COVID-19 感染）的当前证据。URTI，包括 COVID-19 感染，在择期手术的儿童中很常见且常见。患有 URTI 的儿童围手术期呼吸不良事件的风险增加。围手术期呼吸不良事件是儿科麻醉最严重和影响最大的后果之一，包括心跳呼吸骤停，因此对儿科麻醉师提出了重大挑战。本综述讨论了 URTI 的病理生理学和时间进程，包括 COVID-19。总结了围手术期呼吸不良事件的循证患者、麻醉和手术危险因素。这些风险因素协同作用，以确定个体患者的风险，并允许在临床上和经过验证的评分系统中进行风险分层。对可改变的呼吸危险因素进行循证优化可以降低围手术期支气管痉挛的风险。讨论了麻醉管理方案的证据，包括手术的时间和设置、儿科麻醉师的经验、术前用药、气道装置的选择、诱导和维持麻醉的药物的选择、深部与清醒气管拔管技术以及风险分层框架。