{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T14:42:53Z","timestamp":1767796973741,"version":"3.49.0"},"reference-count":26,"publisher":"BMJ","issue":"12","license":[{"start":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T00:00:00Z","timestamp":1766016000000},"content-version":"unspecified","delay-in-days":17,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,11,11]]},"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The objective of this study was to determine the incidence and predictors of intraoperative hypoxaemia and bradycardia in paediatric patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study design and setting<\/jats:title>\n                    <jats:p>A single-arm prospective cohort study was conducted, and data collection was carried out from 15 February 2024 to 30 September 2024 at Wachemo University, Nigest Elleni Mohammed Memorial Comprehensive Specialised Hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>The study included all paediatric patients undergoing surgery who had American Society of Anaesthesiologists classes II and III.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary outcome measures<\/jats:title>\n                    <jats:p>Incidence and predictors of intraoperative hypoxaemia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Secondary outcome measures<\/jats:title>\n                    <jats:p>Incidence and predictors of intraoperative bradycardia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The incidence of intraoperative hypoxaemia was 33.3%. Paediatric age (&lt;1 year), presence of comorbidities, use of muscle relaxants, use of narcotics and duration of surgery (\u22651 hour) were predictors of intraoperative hypoxaemia, with p&lt;0.005\u2009and adjusted OR values of 5.3 (2.1\u20136.1), 4.1 (1.91\u20135.34), 3.1 (1.1\u20135.31), 4.01 (2.5\u20137.1) and 3.2 (1.41\u20136.1), respectively. However, the type of surgery was not associated with intraoperative hypoxaemia (p=0.081).<\/jats:p>\n                    <jats:p>This study has been conducted in a resource-limited setting and with methodological limitations such as short follow-up period, employing a single-arm cohort design, utilisation of sub-standardised intraoperative vital sign monitoring, proper intraoperative event documentation, over-reporting and under-reporting of the findings. This can cause overestimation of the incidence of hypoxaemia compared with studies conducted in a good resource set-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The incidence of intraoperative hypoxaemia and bradycardia, which is significantly associated with comorbidities, age (&lt;1 year), use of opioids and muscle relaxants and surgeries lasting &gt;1 hour, is high in paediatric patients who undergo surgery with general anaesthesia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Research registration<\/jats:title>\n                    <jats:p>\n                      Research registration unique identifying number (UIN) 10811 (\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.researchregistry.com\">https:\/\/www.researchregistry.com<\/jats:ext-link>\n                      ).\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-105476","type":"journal-article","created":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T11:50:33Z","timestamp":1766145033000},"page":"e105476","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Incidence and predictors of intraoperative hypoxaemia and bradycardia in different paediatric age groups in teaching and comprehensive specialised tertiary hospital in resource-constrained setting: a prospective observational cohort study"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1414-9888","authenticated-orcid":false,"given":"Sintayehu Samuel","family":"Lorato","sequence":"first","affiliation":[{"name":"Department of Anesthesia, College of Medicine and Health Science, Wachemo University, Hossana, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-9634-5985","authenticated-orcid":false,"given":"Yisehak","family":"Wolde","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, College of Medicine and Health Science, Wachemo University, Hossana, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yidnekachew","family":"Dedachew","sequence":"additional","affiliation":[{"name":"Department of Emergency and critical care, College of Medicine and Health Science, Wachemo University, Hossana, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Endale","family":"Fikre","sequence":"additional","affiliation":[{"name":"Department of Surgery, Wachemo University, Hossana, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-0014-4396","authenticated-orcid":false,"given":"Zekarias","family":"Markos","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, College of Medicine and Health Science, Wachemo University, Hossana, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mitiku","family":"Desalegn","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, College of Medicine and Health Science, Wachemo University, Hossana, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,12,19]]},"reference":[{"key":"2026010703475623000_15.12.e105476.1","first-page":"2072","article-title":"Pediatric anesthesia adverse events: the Thai Anesthesia Incidents Study (THAI Study) database of 25,098 cases","volume":"90","author":"Bunchungmongkol","year":"2007","journal-title":"J Med Assoc Thai"},{"key":"2026010703475623000_15.12.e105476.2","doi-asserted-by":"crossref","first-page":"223","DOI":"10.4236\/pp.2024.156013","article-title":"Comparison of Propofol and Fentanyl for Preventing Emergence Agitation Following Sevoflurane Anesthesia in Pediatric Patients: A Single-Center Study in Bangladesh","volume":"15","author":"Khan","year":"2024","journal-title":"PP"},{"key":"2026010703475623000_15.12.e105476.3","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-014-3407-4"},{"key":"2026010703475623000_15.12.e105476.4","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aer058"},{"key":"2026010703475623000_15.12.e105476.5","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000002847"},{"key":"2026010703475623000_15.12.e105476.6","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0b013e3181f2eacf"},{"key":"2026010703475623000_15.12.e105476.7","doi-asserted-by":"crossref","DOI":"10.1136\/qshc.2002.004457","article-title":"Crisis management during anaesthesia: bronchospasm","volume":"14","author":"Westhorpe","year":"2005","journal-title":"Qual Saf Health Care"},{"key":"2026010703475623000_15.12.e105476.8","unstructured":"Lens JA , Hermanides J , Houweling PL , et al . 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