Effect of general anesthesia in patients with cerebral palsy at the turn of the new millennium: a population-based study evaluating perioperative outcome and brief overview of anesthetic implications of this coexisting disease

The severity of preoperative cerebral palsy appears to correlate directly with postoperative complications. The primary aim of this study was to characterize the frequency of perioperative morbidity and mortality in cerebral palsy patients undergoing anesthesia. This was accomplished by undertaking...

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Published inJournal of child neurology Vol. 27; no. 7; p. 859
Main Authors Wass, C Thomas, Warner, Mary E, Worrell, Gregory A, Castagno, Julie A, Howe, Melinda, Kerber, Kimberly A, Palzkill, Jenna M, Schroeder, Darrell R, Cascino, Gregory D
Format Journal Article
LanguageEnglish
Published United States 01.07.2012
Subjects
Adult
Anesthesia, General - adverse effects
Cerebral Palsy - epidemiology
Cerebral Palsy - mortality
Cerebral Palsy - surgery
Cerebral Palsy - therapy
Child
Child, Preschool
Community Health Planning
Confidence Intervals
Female
Humans
Hypotension - etiology
Male
Malignant Hyperthermia
Multivariate Analysis
Perioperative Care
Postoperative Complications
Risk Factors
Survival Rate
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Summary:The severity of preoperative cerebral palsy appears to correlate directly with postoperative complications. The primary aim of this study was to characterize the frequency of perioperative morbidity and mortality in cerebral palsy patients undergoing anesthesia. This was accomplished by undertaking a systematic review of the Mayo Database. The risk for perioperative adverse events was 63.1% (95% confidence interval 59.8%-66.5%). However, it deserves clarification that hypothermia and clinically significant yet non-life-threatening hypotension represented the majority (80%) of these complications. When these 2 events are excluded, the rate of adverse perioperative events was 13.1% (95% confidence interval 10.8%-15.5%). Risk factors associated with increased risk included American Society of Anesthesiologists physical status score exceeding 2, history of seizures, upper airway hypotonia, general surgery procedures, and adults. Our findings are useful to counsel patients with cerebral palsy, their caregivers, and their guardians regarding the risk of general anesthesia.
ISSN:1708-8283
DOI:10.1177/0883073811428378