A retrospective analysis of anesthesiologic complications in pediatric neurosurgery

Aleksic, Valentina; Radulovic, D.; Milakovic, Branko; Nagulić, M; Vučović, Dragan; Antunović, Vaso; Djordjević, Milan

doi:10.1111/j.1460-9592.2009.03096.x

Cited by 34 publications

(24 citation statements)

References 18 publications

(19 reference statements)

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“…10,25 To our knowledge, there are only 2 reports of complications in pediatric neurosurgery, only one of which (our previous study 1,2 ) mentions intraoperative complications separately.…”

Section: Neurosurgical Iocsmentioning

confidence: 99%

“…In the pediatric anesthesiological literature, the rate of anesthesiological complications is 2.8%-9.6%. 2,12,23 Tay et al reported a 3.4% IOC rate in their neurosurgical subgroup, whereas the IOC rate was 2.8% for all pediatric anesthesiological procedures. It is possible that what we counted as a neurosurgical complication was counted as an anesthesiological complication in that study (especially hemodynamic complications with a surgical cause).…”

Section: Anesthesiological Complicationsmentioning

confidence: 99%

“…Only 1 study has reported solely anesthesiological complications in a pediatric neurosurgery patient cohort. In a retrospective study over the period 1996-2000, Aleksic et al 2 reported a 9.6% IOC rate, with surgery duration greater than 240 minutes, surgery in the sitting position, and comorbidity as special risk factors. Major reasons for this higher rate may be that in their series, the anesthesiological procedures were all performed by general anesthesiologists, and their study is from a much earlier time period.…”

Section: Anesthesiological Complicationsmentioning

confidence: 99%

“…2,4,14,23 In developed countries, the perioperative mortality rate is 0.42-6.8 per 10,000 anesthetics. 14 Most of the fatalities are associated with airway or cardiocirculatory events.…”

Section: Anesthesiological Complicationsmentioning

confidence: 99%

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Intraoperative complications in pediatric neurosurgery: review of 1807 cases

Lindert¹,

Arts

Blok

et al. 2016

PED

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OBJECTIVE Minimal literature exists on the intraoperative complication rate of pediatric neurosurgical procedures with respect to both surgical and anesthesiological complications. The aim of this study, therefore, was to establish intraoperative complication rates to provide patients and parents with information on which to base their informed consent and to establish a baseline for further targeted improvement of pediatric neurosurgical care. METHODS A clinical complication registration database comprising a consecutive cohort of all pediatric neurosurgical procedures carried out in a general neurosurgical department from January 1, 2004, until July 1, 2012, was analyzed. During the study period, 1807 procedures were performed on patients below the age of 17 years. RESULTS Sixty-four intraoperative complications occurred in 62 patients (3.5% of procedures). Intraoperative mortality was 0.17% (n = 3). Seventy-eight percent of the complications (n = 50) were related to the neurosurgical procedures, whereas 22% (n = 14) were due to anesthesiology. The highest intraoperative complication rates were for cerebrovascular surgery (7.7%) and tumor surgery (7.4%). The most frequently occurring complications were cerebrovascular complications (33%). CONCLUSIONS Intraoperative complications are not exceptional during pediatric neurosurgical procedures. Awareness of these complications is the first step in preventing them.

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“…10,25 To our knowledge, there are only 2 reports of complications in pediatric neurosurgery, only one of which (our previous study 1,2 ) mentions intraoperative complications separately.…”

Section: Neurosurgical Iocsmentioning

confidence: 99%

Section: Anesthesiological Complicationsmentioning

confidence: 99%

Section: Anesthesiological Complicationsmentioning

confidence: 99%

“…2,4,14,23 In developed countries, the perioperative mortality rate is 0.42-6.8 per 10,000 anesthetics. 14 Most of the fatalities are associated with airway or cardiocirculatory events.…”

Section: Anesthesiological Complicationsmentioning

confidence: 99%

See 2 more Smart Citations

Intraoperative complications in pediatric neurosurgery: review of 1807 cases

Lindert¹,

Arts

Blok

et al. 2016

PED

View full text Add to dashboard Cite

show abstract

“…Recent studies [4,5,6] have reported rates for complications related to anesthesia and surgical procedures of 5.5–40%; the most frequent complications are cerebrospinal fluid leaks, new neurological deficits, obstruction and infection of ventriculoperitoneal shunts, significant bleeding and bradyarrhythmia during the initiation of anesthesia. These studies listed the major complications according to the type of surgery; however, the magnitude of their impact on the progress of the patients remains unknown.…”

Section: Introductionmentioning

confidence: 99%

Perioperative Factors Associated with Prolonged Intensive Care Unit and Hospital Length of Stay after Pediatric Neurosurgery

Filho

Carvalho²,

Cavalheiro³

et al. 2011

Pediatr Neurosurg

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Objectives: This study aims to describe the association between different postoperative complications and the length of hospital stay among children undergoing neurosurgical procedures. Methods: A retrospective cohort study was carried out between May 2004 and May 2009 in a tertiary community hospital. All postoperative complications following neurosurgical procedures and their association with the main outcomes [length of intensive care unit (ICU) and hospital stay] were investigated in a univariate and multivariate analysis. Results: The medical records of 198 patients treated during the study period were reviewed. The most frequently performed surgeries were ventriculoperitoneal shunting (16.7%), correction of craniosynostosis (30%) and brain tumor resections (28.3%). Of the 198 patients eligible for this analysis, 79 (39.9%) suffered from at least one complication. The most frequent complications were fever (30.3%), hypothermia (16%), postextubation laryngitis (15.1%) and postoperative bleeding (7%). Factors independently associated with a longer pediatric ICU stay were fever (odds ratio 1.39, 95% confidence interval 1.1–3.2; p = 0.001), laryngitis (odds ratio 2.24, 95% confidence interval 1.8–5.2; p = 0.001), postoperative bleeding requiring reoperation (odds ratio 1.8, 95% confidence interval 1.4–3.9; p < 0.001) and infection (odds ratio 3.71, 95% confidence interval 1.8–12.4; p = 0.033). Fever (odds ratio 2.54, 95% confidence interval 2–7.4; p = 0.001) and infection (odds ratio 11.23, 95% confidence interval 4–22.4; p = 0.003) were related to the total length of the patient’s hospital stay. Conclusions: In this study population, most elective neurosurgical procedures were not associated with significant complications, and morbidity and mortality were low. Some complications significantly influenced patients’ outcomes and should be monitored for early diagnosis. This study may improve our understanding and identification of postoperative outcomes in pediatric neurosurgery.

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Neurosurgical morbidity in pediatric supratentorial midline low‐grade glioma: Results from the German LGG studies

Weiss

Thomale

Schulz

et al. 2023

Intl Journal of Cancer

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Surgical resection is a mainstay of treatment for pediatric low‐grade glioma (LGG) within all current therapy algorithms, yet associated morbidity is scarcely reported. As supratentorial midline (SML) interventions are particularly challenging, we investigated the frequency of neurosurgical complications/new impairments aiming to identify their risk factors. Records were retrospectively analyzed from 318 patients with SML‐LGG from successive German multicenter LGG studies, undergoing surgery between May 1998 and June 2020. Exactly 537 operations (230 resections, 167 biopsies, 140 nontumor procedures) were performed in 318 patients (54% male, median age: 7.6 years at diagnosis, 9.5 years at operation, 11% NF1, 42.5% optic pathway glioma). Surgical mortality rate was 0.93%. Applying the Drake classification, postoperative surgical morbidity was observed following 254/537 (47.3%) and medical morbidity following 97/537 (18.1%) patients with a 40.1% 30‐day persistence rate for newly developed neurological deficits (65/162). Neuroendocrine impairment affected 53/318 patients (16.7%), visual deterioration 34/318 (10.7%). Postsurgical morbidity was associated with patient age <3 years at operation, tumor volume ≥80 cm3, presence of hydrocephalus, complete resection, surgery in centers with less than median reported tumor‐related procedures and during the earlier study period between 1998 and 2006, while the neurosurgical approach, tumor location, NF1 status or previous nonsurgical treatment were not. Neurosurgery‐associated morbidity was frequent in pediatric patients with SML‐LGG undergoing surgery in the German LGG‐studies. We identified patient‐ and institution‐associated factors that may increase the risk for complications. We advocate that local multidisciplinary teams consider the planned extent of resection and surgical skills.

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A retrospective analysis of anesthesiologic complications in pediatric neurosurgery

Abstract: The duration of anesthesia, the sitting position of the patient, and the presence of comorbidities significantly increase the risk of anesthesia complications in pediatric neurosurgery.

Cited by 34 publications

References 18 publications

Intraoperative complications in pediatric neurosurgery: review of 1807 cases

Intraoperative complications in pediatric neurosurgery: review of 1807 cases

Perioperative Factors Associated with Prolonged Intensive Care Unit and Hospital Length of Stay after Pediatric Neurosurgery

Neurosurgical morbidity in pediatric supratentorial midline low‐grade glioma: Results from the German LGG studies

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