Comparison of Preoperative Inhaled Budesonide With Salbutamol on the Respiratory Adverse Effects in Children Undergoing Tonsillectomy

Study Overview
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Brief Summary
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Comparison of preoperative inhaled Budesonide with Salbutamol on the incidence of respiratory adverse effects in children undergoing tonsillectomy

Detailed Description
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Comparison of preoperative inhaled Budesonide with Salbutamol on the incidence of respiratory adverse effects in children undergoing tonsillectomy Adenotosillectomy is routinely performed for children with sleep disordered breathing or recurrent infectious tonsillitis. Although the safety of the pediatric anesthesia is constantly improving, a substantial proportion of children undergoing tonsillectomies experience pre operative respiratory adverse events with a prevalence up to 50% in children with at least one risk factor. Both minor adverse effects such as oxygen desaturation airway, obstruction coughing or wheezing and the major events such as laryngospasm and/ or bronchospasm occur more commonly undergoing tonsillectomy compared with other non airway surgery.

Official Title
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Comparison of Preoperative Inhaled Budesonide With Salbutamol on the Respiratory Adverse Effects in Children Undergoing Tonsillectomy

Conditions
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Preoperative Inhalation of Budesonide and Salbutamol in Children Undergoing Tonsillectomy

Intervention / Treatment
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* Drug: Salbutamol
* Drug: Budesonide
* Other: Saline


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: children scheduled for elective tonsillectomy with or without adenoidectomy, grommets cautery of inferior turbinates. Age more than or equal 5 years and less than or equal to 12 years. Both genders No obvious abnormalities in preoperative ECG, blood routine electrolytes and other tests. ASA class 1 Exclusion Criteria: Patients with Known hypersensitivity to any of the drugs that would be used in the study Patients that are immunologically compromised Sleep apnea syndrome or difficult airway Pre-existing hypoxemia is SpO2 < 90% History of adverse events with prior sedation or patients who had taken any sedative drugs within the last 24 hours. Parents refusal

Ages Eligible for Study
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Minimum Age: 5 Years
Maximum Age: 12 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: salbutamol<br>children will receive 0.15 milligram per kilogram of salbutamol diluted with normal saline to a total volume of 4 ml by inhalation 20 minutes preoperatively | Drug: Salbutamol<br>* inhalation anaesthesia<br>|
| Active Comparator: budesonide<br>children will receive 0.5 milligram per kilogram of budesonide diluted with normal saline to a total volume of 4 ml by inhalation 20 minutes preoperatively | Drug: Budesonide<br>* inhalation anaesthesia<br>|
| Placebo Comparator: normal saline<br>children will receive 0.4 ml of normal saline 0.9 by inhalation 20 minutes preoperatively | Other: Saline<br>* saline<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| incidence of preoperative respiratory adverse events. | Will be the incidence of preoperative respiratory adverse events. events will be reported by the attending an anesthetist or PACU nurse on a dedicated data collection sheet and will be recorded against the phase of anesthesia (induction, maintenance, emergency, or recovery) during which the event occurred | 1 year | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| frequency of the individual PRAEs | Will be the frequency of the individual PRAEs, incidence of PRAEs during the induction and recovery periods, recovery time (the time from the end of surgery to discharge from PACU) | 1 year |