Anestesia e paralisia cerebral

Maranhão, Marcius Vinícius M.

doi:10.1590/s0034-70942005000600012

Cited by 29 publications

(19 citation statements)

References 40 publications

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“…2 However, the common denominator is the presence of motor dysfunction arising from nonprogressive lesions or abnormalities in the brain sustained early in life. 1,3–5 Anecdotally, the severity of preoperative cerebral palsy appears to correlate directly with postoperative complications. However, more definitive evidence is lacking as to whether these individuals are truly at increased perioperative risk for adverse events.…”

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confidence: 99%

Effect of General Anesthesia in Patients With Cerebral Palsy at the Turn of the New Millennium

et al. 2011

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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.

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confidence: 99%

Effect of General Anesthesia in Patients With Cerebral Palsy at the Turn of the New Millennium

et al. 2011

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“…Decreased airway tone and increased risk of aspiration are frequent in neurologically handicapped patients, and a medical practitioner must focus on patients identified as high risk for aspiration during induction and endotracheal extubation [20]. Generally, epilepsy is present in approximately 30% of cerebral palsy patients [21]. In this study, 32 of 51 patients (62.7%) took anti-epileptic drugs, and the general anesthesia in these patients may aggravate the frequency and duration of seizure activity.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Percutaneous Endoscopic Gastrostomy and Surgical Gastrostomy in Severely Handicapped Children

Kim

Lee

Kim

et al. 2017

Pediatr Gastroenterol Hepatol Nutr

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PurposeGastrostomy is commonly used procedures to provide enteral nutrition support for severely handicapped patients. This study aimed to identify and compare outcomes and complications associated with percutaneous endoscopic gastrostomy (PEG) and surgical gastrostomy (SG).MethodsA retrospective chart review of 51 patients who received gastrostomy in a single tertiary hospital from January 2000 to May 2016 was performed. We analyzed the patients and the complications caused by the procedures.ResultsAmong the 51 patients, 26 had PEG and 25 had SG. Four cases in the SG group had fundoplication for gastroesophageal reflux disease. PEG and SG groups were followed up for an average of 29 months and 44 months. Major complications occurred in 19.2% of patients in the PEG group and 20.0% in the SG group, but significant differences between the groups were not observed. Minor complications occurred in 15.4% of patients in the PEG group and 52.0% in the SG group. Minor complications were significantly lower in the PEG group than in the SG group (p=0.006). The average use of antibiotics in the PEG and SG groups was 6.2 days and 15.7 days (p=0.002). Thirteen patients died of underlying disease but not related to gastrostomy, and only one patient died due to complications associated with general anesthesia.ConclusionThe duration of antibiotics use and incidence of minor complications were significantly lower in the PEG group than those in the SG group. Early PEG could be recommended for nutritional supports.

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“…Pain can contribute to the worse of swallowing and thus airway secretion levels, therefore analgesy is important for the successful management of these children. Opioids such as morphine, codein and tramadol, although potent painkillers, are associated with a high level of side effects, including nausea, vomiting and respiratory depression, and should be avoided [23].…”

Section: Discussionmentioning

confidence: 99%

Postoperative acute respiratory insufficiency following adenotonsillectomy in children with neuropathy

Manrique

Sato

Anastacio

2008

International Journal of Pediatric Otorhinolaryngology

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Anestesia e paralisia cerebral

Cited by 29 publications

References 40 publications

Effect of General Anesthesia in Patients With Cerebral Palsy at the Turn of the New Millennium

Effect of General Anesthesia in Patients With Cerebral Palsy at the Turn of the New Millennium

Comparison of Percutaneous Endoscopic Gastrostomy and Surgical Gastrostomy in Severely Handicapped Children

Postoperative acute respiratory insufficiency following adenotonsillectomy in children with neuropathy

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