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Upper respiratory tract infection before elective surgery — FRCA Final MCQ

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ModeratePaediatricUpper respiratory tract infection before elective surgeryFRCA Final

A 4-year-old child presents for dental extractions. He has coryza, moist cough, temperature 38.2°C, scattered wheeze and reduced appetite. His oxygen saturation is 94% on air and surgery is elective. What is the most appropriate anaesthetic technique?

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Correct answer: A — Postpone surgery and treat the respiratory illness

An elective child with fever, moist cough, wheeze and reduced oxygen saturation has a higher risk of peri-operative respiratory adverse events, so postponement is appropriate. Proceeding with intubation would increase laryngospasm and bronchospasm risk. Desflurane is irritant to paediatric airways. The decision differs for mild isolated coryza, where risk-benefit may support proceeding.

Reference: APAGBI paediatric preassessment guidance 2022; RCoA GPAS paediatric anaesthesia