A world-first Perth study has shown that two puffs of an over-the-counter asthma medication before surgery can reduce respiratory complications during and after tonsillectomy surgery in children.
The results from the clinical trial – a collaborative project between Perth Children’s Hospital (PCH), Telethon Kids Institute, Perth Children’s Hospital Foundation, The University of Western Australia, and Curtin University – were recently published in the international journal JAMA Pediatrics.
Lead researcher and PCH anaesthetist Professor Britta Regli-von Ungern-Sternberg said tonsillectomy was one of the most frequently performed surgical procedures in children.
“In Western Australia, tonsillectomy is a common operation in children and up to half of those having this procedure will experience breathing problems at some stage during or after the procedure,” Professor Regli-von Ungern-Sternberg said.
“Although most of these complications are minor, such as easily managed airway obstructions and mild desaturations, others can be more serious and have long-term effects.”
Professor Regli-von Ungern-Sternberg said the randomised clinical trial involved 479 children aged 0 to 8 years undergoing anaesthesia for tonsillectomy surgery at PCH.
“This clinical trial showed that children who had two puffs of the asthma medication, commonly known as Ventolin, before tonsillectomy surgery had a clinically significant reduction in respiratory complications compared to those who didn’t have Ventolin,” she said.
Of the 241 children randomised to receive Ventolin, 67 had respiratory complications (27.8%), compared to 114 of 238 who received the placebo (47.9%). Laryngospasm, coughing, and oxygen desaturation each occurred significantly more often in the placebo group.
Telethon Kids’ Professor Graham Hall said the benefits of giving two puffs of Ventolin pre-surgery should be considered when planning anaesthesia for children undergoing tonsillectomy.
"This study will change the way children getting tonsillectomies are managed,” Professor Hall said. “We demonstrated a simple, effective solution that helps to greatly reduce breathing problems during surgery.
“It’s possible that Ventolin could also be beneficial for children having other types of surgery and more research is needed in this area.”
Professor Hall said clinical trials were vital to ensuring the continued improvement of clinical care in kids.
"The Children's Lung Health team at Telethon Kids was excited to be able to collaborate with clinicians and researchers at Perth Children's Hospital, Curtin and UWA to help improve outcomes in kids having surgery," he said.
This clinical trial was funded by the Perth Children’s Hospital Foundation and an Australia and New Zealand College of Anaesthetists (ANZCA) project grant.
First published Friday 12 July 2019.