PMID- 27219118
OWN - NLM
STAT- MEDLINE
DCOM- 20170303
LR  - 20171027
IS  - 1460-9592 (Electronic)
IS  - 1155-5645 (Linking)
VI  - 26
IP  - 7
DP  - 2016 Jul
TI  - The STBUR questionnaire for identifying children at risk for sleep-disordered 
      breathing and postoperative opioid-related adverse events.
PG  - 759-66
LID - 10.1111/pan.12934 [doi]
AB  - BACKGROUND: Children with symptoms of sleep-disordered breathing (SDB) appear to 
      be at risk for perioperative respiratory events (PRAE). Furthermore, these 
      children may be more sensitive to the respiratory-depressant effects of opioids 
      compared with children without SDB. AIMS: The aim of this prospective 
      observational study was to confirm that otherwise healthy children with symptoms 
      of SDB are at greater risk for PRAE compared with children with no symptoms and 
      to determine if these children are also at increased risk for postoperative 
      opioid-related adverse events (ORAE). METHODS: Six hundred and seventy-eight 
      parents of children scheduled for surgery completed the Snoring, Trouble 
      Breathing, and Un-Refreshed (STBUR) questionnaire preoperatively. Data regarding 
      the incidence of PRAE were collected prospectively. Postoperative pulse oximetry 
      desaturation alarm events were downloaded from the institutional secondary alarm 
      notification system. RESULTS: Children with symptoms of SDB per STBUR (>/=3 
      symptoms) had a two-fold increased likelihood of PRAE compared with children 
      without SDB (52.8% vs 27.9% respectively, LR(+) = 2.00, 95% CI = 1.60-2.49, P = 
      0.0001). A subset analysis of children undergoing airway procedures requiring 
      hospital admittance (n = 179) showed that those with SDB were given the same 
      postoperative opioid doses as children without SDB. However, children with SDB 
      symptoms generated a greater number of postoperative oxygen desaturation alarms 
      (14.14 +/- 29.3 vs 7.12 +/- 13.2, mean difference = 7.02, 95% CI = 0.39-13.64, P = 
      0.038) and more frequently required escalation of care (15.3% vs 7.1%, LR(+) = 
      1.67, 95% CI = 1.22-2.16, P = 0.001) compared with children with no SDB symptoms. 
      CONCLUSIONS: Children presenting for surgery with SDB symptoms are at increased 
      risk for PRAE. Children undergoing airway-related procedures also appear to be at 
      increased risk for ORAE. Furthermore, regardless of the preoperative assessment 
      of risk using the STBUR questionnaire, children received the same doses of 
      opioids postoperatively. Given the increased incidence of postoperative oxygen 
      desaturations among children with SDB symptoms, it would seem prudent to consider 
      titration of opioid doses according to identified risk.
CI  - (c) 2016 John Wiley & Sons Ltd.
FAU - Tait, Alan R
AU  - Tait AR
AD  - Department of Anesthesiology, University of Michigan Health System, Ann Arbor, 
      MI, USA.
FAU - Bickham, Rebecca
AU  - Bickham R
AD  - Department of Anesthesiology, University of Michigan Health System, Ann Arbor, 
      MI, USA.
AD  - The University of Michigan Medical School, University of Michigan Health System, 
      Ann Arbor, MI, USA.
FAU - O'Brien, Louise M
AU  - O'Brien LM
AD  - Department of Neurology, University of Michigan Health System, Ann Arbor, MI, 
      USA.
AD  - Department of Oral/Maxillofacial Surgery, University of Michigan Health System, 
      Ann Arbor, MI, USA.
AD  - The Michael S. Aldridge Sleep Disorders Center, University of Michigan Health 
      System, Ann Arbor, MI, USA.
FAU - Quinlan, Megan
AU  - Quinlan M
AD  - Department of Anesthesiology, University of Michigan Health System, Ann Arbor, 
      MI, USA.
AD  - The University of Michigan Medical School, University of Michigan Health System, 
      Ann Arbor, MI, USA.
FAU - Voepel-Lewis, Terri
AU  - Voepel-Lewis T
AD  - Department of Anesthesiology, University of Michigan Health System, Ann Arbor, 
      MI, USA.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20160524
PL  - France
TA  - Paediatr Anaesth
JT  - Paediatric anaesthesia
JID - 9206575
RN  - 0 (Analgesics, Opioid)
SB  - IM
CIN - Paediatr Anaesth. 2017 Mar;27(3):329. PMID: 28220664
MH  - Adolescent
MH  - Analgesics, Opioid/*adverse effects
MH  - Child
MH  - Child, Preschool
MH  - Female
MH  - Humans
MH  - Male
MH  - Postoperative Complications/*chemically induced/prevention & control
MH  - Prospective Studies
MH  - Risk Factors
MH  - Sleep Apnea Syndromes/*chemically induced/prevention & control
MH  - *Surveys and Questionnaires
OTO - NOTNLM
OT  - adverse events
OT  - child
OT  - opioids
OT  - perioperative
OT  - sleep-disordered breathing
EDAT- 2016/05/25 06:00
MHDA- 2017/03/04 06:00
CRDT- 2016/05/25 06:00
PHST- 2016/04/21 00:00 [accepted]
PHST- 2016/05/25 06:00 [entrez]
PHST- 2016/05/25 06:00 [pubmed]
PHST- 2017/03/04 06:00 [medline]
AID - 10.1111/pan.12934 [doi]
PST - ppublish
SO  - Paediatr Anaesth. 2016 Jul;26(7):759-66. doi: 10.1111/pan.12934. Epub 2016 May 
      24.