Uti

1. Upper Respiratory Tract
Infection
Prepared By Mr Mudassir Iqbal
Anesthesia Department
IHS Laki Marwat

3. Upper Respiratory Tract
Infection
• Upper Respiratory Tract Infection refers to
infections involving the nose, sinuses, pharynx, or
larynx.
• It is Also called URTI.
• It's important to note that there are several types
of infections that can affect different parts of the
upper respiratory system

4. Types of URTI
• Common Cold: The common cold is one of the
most prevalent types of URTIs.
• Sinusitis: Sinusitis refers to inflammation or
infection of the sinuses, which are air-filled
cavities in the facial bones around the nose.
• Pharyngitis/Tonsillitis: Pharyngitis is inflammation
of the throat, while tonsillitis specifically refers to
inflammation of the tonsils.

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• Laryngitis: Laryngitis is inflammation of the larynx
(voice box).
• Epiglottitis: Epiglottitis is a rare but potentially
serious infection of the epiglottis, a flap of tissue
that covers the opening of the windpipe during
swallowing.

6. Causes of URTI
• Most common causes of upper Respiratory Tract
Infection are
• Viruses ( Most common cause of URTI )
• Bacteria
• Fungi

7. Sign & Symptoms
• Common symptoms of URTI include
• Fever
• Headache
• Body pain
• Cough
• Sore throat,
• Runny or stuffy nose,
• Fatigue

8. Diagnosis
• Subjective symptoms
• Physical examination
• Rapid strep Test (For bacterial Infection)
• Nasal swab
• Throat swab
• sputum Test

9. Treatment
• The treatment of URTI is typically symptomatic.
• NSAIDs (acetaminophen or ibuprofen) to relieve
pain and fever.
• Antibiotics (Only for Bacterial infection)
• Lozenges
• Drinking plenty of fluids
• Getting rest can also help.

10. Anesthetic Management
• Elective surgery in patient with upper respiratory
tract infection (URTI) depends on the severity of
the disease.
• Patients with minimal URTI (viral infections), i.e.
only running nose, occasional cough without
expectoration can go ahead with elective surgery.

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• However if the patient has significant URTI, i.e.
significant cough or cough with expectoration,
fever, signs of upper airway obsuuction like stridor
,sore Throat
• Then elective surgery should ideally be deferred
for 6 weeks.

12. Pre-operative Management
• NSAIDs
• Supplemental Oxygen (if required)
• Antibiotics ( For Bacterial infection)
• Corticosteroids
• Suction of oral cavity
• Fluid (if required)

13. Choice of Anesthesia
• Choice of Anesthesia is regional.
• If GA is to be given then prefer to get the surgery
done under laryngeal mask airway (LMA).
• Avoid intubation as far as possible, however, if
intubation is necessary then reflex stimulation of
airways by laryngoscopy and intubation should be
prevented.

14. Intra-operative Management
• Induction Agents of choice is Propofol, Ketamine
and Etomodate.
• For maintenance of Anesthesia sevoflurane is
preffered, propofol can be used for maintenance
also.
• Humidification of gases is must.
• Be ready for cricothyroidotomy and/ or
tracheostomy should there occur significant upper
airway obstruction.

15. Post-operative Management
• Patients undergoing surgery with active URTI are
prone to develop complications like
• laryngospasm (5 times), (Deep Anesthesia)
• bronchospasm (10 times),
• hypoxia, (supplemental oxygen)
• Increased bleeding from airways,
• Lower respiratory tract infection (infection may
spread to lower respiratory tract by intubation
leading to pneumonitis, atelectasis or even
septicemia).