Upper respiratory tract infections (URTIs) in children are associated with an increased risk of peri-operative respiratory adverse events. However, decision-making regarding proceeding with general anaesthesia remains variable, with limited consensus on optimal management.

Methods

An anonymised electronic survey  (regional east of England ) was distributed to  senior anaesthetists practising paediatric anaesthesia to assess current practices in managing paediatric patients with URTIs. The survey explored factors influencing decision-making, timing of surgery, perceived risks, and awareness of guidelines.

Results

A total of 50 responses were received, of which 42 were consultant anaesthetists.

There was significant variability in clinical practice:

• 76% (38/50) reported variability within their departments
• Only 32% (16/50) were aware of existing guidelines, while the remainder were either unsure or unaware
• The majority considered symptoms such as fever, productive cough, and wheeze as key factors influencing postponement

Approaches to timing of surgery following URTI varied widely, with no clear consensus.

Importantly, 74% (37/50) supported the development of standardised guidelines to improve decision-making.

Discussion

This survey demonstrates substantial variation in the management of paediatric patients with URTIs among anaesthetists. Limited awareness of guidelines and inconsistent practices highlight the need for clear, evidence-based recommendations and improved risk stratification tools to support safer and more consistent peri-operative care.