Background: Paediatrics requires more oxygen than do adults, which affects how rapidly the body desaturates following apnoea. Children with anatomically complex airways are more likely to experience unfavourable airway events. These adverse events include hypoxemia, bradycardia, cardiac arrest, severe airway damage, and death. The objective of this study was to determine the incidence and predictors of intraoperative hypoxemia and bradycardia in paediatric patients.

Methods: A single-arm prospective single-centre cohort study with meticulous random selection was conducted on 422 pediatric patients. Data entry and analysis were performed with the Statistical Package for Social Sciences (SPSS) version 26.00 software. For logistic regression, the Hosmer–Lemeshow goodness-of-fit test was applied. Binomial logistic regression and multivariate analysis were used. Pearson’s chi-square test was used to determine the correlation between variables, with p < 0.05 indicating statistical significance.

RESULTS: The incidence of intraoperative hypoxemia was 33.3%. Pediatric age (<one year), the presence of comorbidities, the use of muscle relaxants, the use of narcotics, and the duration of surgery (≥one hour) were predictors of intraoperative hypoxemia, with p<0.005 and AOR values of 5.3 (2.1--6.1), 4.1 (1.91--5.34), 3.1 (1.1--5.31), 4.01 (2.5--7.1), and 3.2 (1.41--6.1), respectively. However, the type of surgery was not associated with intraoperative hypoxemia (p=0.081).

Conclusion: Pediatric patients who undergo surgery with GA have a high incidence of intraoperative hypoxemia and bradycardia, which is significantly associated with comorbidities, age (<1 year), use of opioids and muscle relaxants and surgeries lasting more than one hour.

Keywords: Paediatrics surgery, Intraoperative hypoxemia, Bradycardia, Incidence

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