The effect of passive smoking on the laryngospasm rate in children sedated during the esophagogastroduodenoscopy

Sibel Seckin Pehlıvan; Ozlem Oz Gergın; Adnan Bayram; Derya Altay; Duran Arslan; Cihangir Biçer; Recep Aksu

doi:10.15537/smj.2022.43.3.20210784

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Table 1

- Demographic characteristics and anesthesia drugs.

Characteristics	Exposure to smoking		P-value
	No	Yes
	n (%)
Gender
Male	88 (41.3)	93 (30.5)	0.001*
Female	125 (58.7)	212 (69.5)	0.001*
Age, years, M (range)	10.0 (5.0-14.0)	11.0 (6.0-15.0)	0.083
Weight (kg), M (range)	30.0 (16.5-48.0)	36.0 (19.0-50.0)	0.060
ASA status
ASA-I	156 (73.2)	238 (78.0)	0.208
ASA-II	57 (26.8)	67(22.0)	0.208
Propofol (mg), M (Q₁-Q₃)	50.0 (30.0-80.0)	50.0 (30.0-80.0)	0.926
Midazolam (mg), M (Q₁-Q₃)	1.5 (1-2)	1.5 (1-2.5)	0.082
Fentanyl (µgr), M (Q₁-Q₃)	20.0 (10.0-30.0)	20.0 (10.0-35.0)	0.178
Duration of endoscopy (min), M (Q₁-Q₃)	8.0 (7.0-12.0)	8.0 (6.0-10.0)	0.385

ASA: American Society of Anesthesiology, M: median, Q₁: first quartile, Q₃: third quartile, *significant difference (p<0.05)

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Table 2

- Hemodynamic parameters.

Parameters	Exposure to smoking		P-value
	No	Yes
	Mean±SD
HR
Before EGD	98.68±19.06	98.10±16.97	0.719
After EGD	89.33±18.42	87.68±16.65	0.288
w-g TI	p<0.001	p<0.001
RR
Before EGD	21.96±4.96	21.78±4.64	0.675
After EGD	17.24±4.51	17.54±4.28	0.445
w-g TI	p<0.001	p<0.001
TA
Before EGD	75.09±13.85	79.10±13.36	0.001
After EGD	69.45±10.93	71.85±11.07	0.015
w-g TI	p<0.001	p<0.001
Et-CO₂
Before EGD	28.06±5.65	27.75±5.96	0.548
After EGD	29.77±4.39	29.99±4.75	0.598
w-g TI	p<0.001	p<0.001
Lidocaine need, n (%)
Yes	15 (7.0)	84 (27.5)	<0.001*
No	198 (93.0)	221 (72.5)	<0.001*

SD: standard deviation, HR: heart rate, EGD: esophagogastroduodenoscopy, RR: respiratuar rate, TA: mean arterial tension, Et-CO₂=end tidal CO₂, w-g TI: intra-group test statistics, *significant difference (p<0.05)

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Table 3

- Comparison of patients’ characteristics by smoking exposure.

Characteristics	Exposure to smoking		Test statistics	P-value
	No (n=213)	Yes (n=305)
	n (%)
Cough
No	187 (87.8)	211 (69.2)	χ²=24.411	<0.001*
Yes	26 (12.2)	94 (30.8)	χ²=24.411	<0.001*
Laryngospasm
No	213 (100)	279 (91.5)	χ²=19.117	<0.001*
Yes	0 (0.0)	26 (8.5)	χ²=19.117	<0.001*
Saturation
>90%	210 (98.6)	268 (87.9)	χ²=20.236	<0.001*
<90%	3 (1.4)	37 (12.1)	χ²=20.236	<0.001*
Lidocaine need
No	198 (93.0)	221 (72.5)	χ²=34.089	<0.001*
Yes	15 (7.0)	84 (27.5)	χ²=34.089	<0.001*

χ²: Chi-squared test, *significant difference (p<0.05)

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Table 4

- Comparisons by exposure to smoking groups.

Variables	Exposure to smoking				P-value
	None (n=213)	Mother (n=35)	Father (n=197)	Both (n=73)
	n (%)
Cough
No	187 (87.8)	22 (62.9)	149 (75.6)	40 (54.8)	<0.001*
Yes	26 (12.2)^{^†}	13 (37.1)^{‡, §}	48 (24.4)^‡	33 (45.2)^§	<0.001*
Laryngospasm
No	213 (100.0)	31 (88.6)	187 (94.9)	61 (83.6)	<0.001*
Yes	0 (0.0)^{^†}	4 (11.4)^‡,§	10 (5.1)^‡	12 (16.4)^§	<0.001*
Saturation
>90%	210 (98.6)	29 (82.9)	183 (92.9)	56 (76.7)	<0.001*
<90%	3 (1.4)^{^†}	6 (17.1)^‡,§	14 (7.1)^‡	17 (23.3)^§	<0.001*
Lidocaine need
No	198 (93.0)	25 (71.4)	154 (78.2)	42 (57.5)	<0.001*
Yes	15 (7.0)^{^†}	10 (28.6)^‡,§	43 (21.8)^‡	31 (42.5)^§	<0.001*

↵^†,‡,§indicates the difference between exposures in each category, *significant difference (p<0.05)

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Table 5

- Binary logistic regression analysis results.

Characteristics	Single binary logistic regression					Multiple binary logistic regression*					Hosmer and Lemeshow test
Characteristics	β	SE	P-value	Exp (β)	95% CI	β	S.E.	P-value	Exp (β)	95% CI	Hosmer and Lemeshow test
Cough
Gender
Male	Ref
Female	0.093	0.220	0.673	1.097	0.71-1.68	-	-	-	-	-
Age, years
16-18	Ref					Ref
1-5	1.153	0.409	0.005	3.167	1.42-7.06	1.289	0.425	0.002	3.629	1.57-8.35
6-10	1.408	0.394	<0.001	4.089	1.88-8.85	1.554	0.408	<0.001	4.728	2.12-10.5	χ²=6.952
11-15	0.836	0.401	0.037	2.307	1.05-5.06	0.920	0.413	0.026	2.509	1.11-5.63	p=0.542
Exposed from
None	Ref					Ref
Mother	1.447	0.408	<0.001	4.250	1.91-9.44	1.594	0.425	<0.001	4.926	2.14-11.3
Father	0.840	0.267	0.002	2.317	1.37-3.91	0.921	0.273	0.001	2.511	1.47-4.29
Both	1.781	0.315	<0.001	3.201	3.20-10.9	1.845	0.323	<0.001	6.329	3.35-11.9
Saturation
Gender
Male	Ref
Female	0.244	0.358	0.496	1.276	0.63-2.57	-	-	-	-	-
Age, years
16-18	Ref
1-5	0.862	0.682	0.207	2.367	0.62-9.01	_-	_-	_-	_-	_-
6-10	1.189	0.648	0.066	3.282	0.92-11.6						χ²=0.001
11-15	0.897	0.655	0.171	2.452	0.68-8.8	-	-	-	-	-	p=0.999
Exposed from
None	Ref					Ref
Mother	2.673	0.734	<0.001	14.893	3.43-61.0	2.673	0.734	<0.001	14.893	3.43-61.0
Father	1.678	0.644	0.009	5.355	1.51-18.9	1.678	0.644	0.009	5.355	1.51-18.9
Both	3.056	0.644	<0.001	21.250	6.01-75.0	3.056	0.644	<0.001	21.250	6.01-75.08
Lidocaine use
Gender
Male	Ref
Female	-0.131	0.232	0.573	0.877	0.55-1.38
Age, years
16-18	Ref					Ref
1-5	0.950	0.435	0.029	2.585	1.10-6.07	1.065	0.455	0.019	2.901	1.18-7.08
6-10	1.306	0.415	0.002	3.690	1.63-8.32	1.479	0.432	0.001	4.388	1.88-10.2	χ²=7.759
11-15	0.727	0.425	0.087	2.069	0.90-4.75	0.805	0.440	0.067	2.237	0.94-5.29	p=0.355
Exposed from
None	Ref					Ref
Mother	1.664	0.460	<0.001	5.280	2.14-13.0	1.764	0.474	<0.001	5.838	2.30-14.7
Father	1.304	0.319	<0.001	3.686	1.97-6.88	1.384	0.324	<0.001	3.993	2.11-7.53
Both	2.277	0.357	<0.001	9.743	4.83-19.6	2.347	0.365	<0.001	10.456	5.11-21.3