[Preoperative anesthesia risk assessment factors in young children with severe recurrent respiratory papillomatosis].

<b>Objective:</b> To investigate the preoperative anesthesia risk assessment factors in young children with severe recurrent respiratory papillomatosis (RRP). <b>Methods:</b> The clinical data of children aged 0-6 years with RRP who were admitted to Beijing Tongren Hospital Affiliated to Capital Medical University from January 2014 to August 2024 were retrospectively included, and the children were divided into severe group and non-severe group according to whether they experienced dyspnea of grade Ⅱ or more severe. Preoperative clinical data of two groups were compared, including previous surgical history, preoperative presence of vocal cord adhesion, endotracheal tumor dissemination, history of tracheotomy and systemic conditions such as fever and respiratory infections, and American Society of Anesthesiologists (ASA) classification, as well as perioperative anesthesia data such as the ratio of a single successful intubation during anesthetic induction, operative time, hypoxic events, and data of recovery from anesthesia. <b>Results:</b> A total of 155 young children with RRP were included, including 93 males and 62 females, with the age of first surgery being 3.5 (2.3, 4.8) years, of which 79 (51%) were severe on each occasion, 43 (27.7%) were non-severe on each occasion, and the remaining 33 (21.3%) had both severe and non-severe RRP during the treatment. The number of surgeries per child ranged from 1 to 72 times and the total number was 686. There were 513 cases in the severe group and 173 cases in the non-severe group. Endotracheal tumor dissemination [14.8% (76/513) vs 6.4% (11/173)], vocal cord adhesion [31.9% (164/513) vs 16.2% (28/173)], history of tracheostomy [9.2% (47/513) vs 1.2% (2/173)], ASA grade Ⅲ-Ⅳ [24. 8% (127/513) vs 10.4% (18/173)], fever [5.3% (27/513) vs 0.6% (1/173)] and respiratory tract infections [8.6% (44/513) vs 3.5% (6/173)] of severe group were higher than non-severe group (all <i>P</i><0.05). The ratio of a single successful intubation [69.6% (357/513) vs 97.7% (169/173)] in severe group was lower than non-severe group. Compared with non-severe group, the severe RRP children had a significantly higher proportion of hypoxia during induction [5.3% (27/513) vs 0.6% (1/173)] and recovery periods [6.0% (31/513) vs 1.2% (2/173)], the operation time [50 (40, 60) versus 38 (30, 50) min], anesthesia recovery time [15 (10, 20) vs 10 (15, 15) min] and post-anesthesia care unit (PACU) recovery time [30(26, 45) vs 30(25, 32) min] (all <i>P</i><0.05). Two of the severe RRP children were transferred to the intensive care unit with endotracheal tube for respiratory support, and were returned to the ward after 24 h with endotracheal tube removed. <b>Conclusion:</b> The perioperative anesthesia risk assessment factors of young children with severe RRP include vocal cord adhesion, history of tracheostomy endotracheal tumor dissemination, ASA grade Ⅲ-Ⅳ and systemic conditions such as fever and respiratory infections.