Shaikh Safiya Imtiaz, Hegade Ganapati
Department of Anaesthesiology, Karnataka Institute of Medical Sciences, Hubli, Karnataka, India.
Anesth Essays Res. 2017 Jul-Sep;11(3):544-549. doi: 10.4103/0259-1162.194569.
Cerebral palsy (CP) refers to a spectrum of nonprogressive neurological disorders with disturbances in posture and movement, resulting from perinatal intrauterine insult to developing infant brain. Many conditions associated with CP require surgery. Such cases pose important gastrointestinal, respiratory, and other perioperative considerations. Anesthetic management in these cases is delicate. Intraoperative complications including hypovolemia, hypothermia, muscle spasms, seizures, and delayed recovery might complicate the anesthetic management. A thorough preanesthetic evaluation allows for a better intra- and post-operative care. Postoperative analgesia is important, particularly in orthopedic surgeries one for pain relief. This review highlights the clinical manifestations in CP and anesthetic considerations in such child presenting for various surgeries.
脑瘫(CP)是指一系列非进行性神经障碍,伴有姿势和运动障碍,由围产期子宫内发育中的婴儿大脑受到损伤引起。许多与脑瘫相关的病症需要手术治疗。此类病例在胃肠道、呼吸及其他围手术期方面存在重要的考虑因素。这些病例的麻醉管理较为棘手。术中并发症包括血容量不足、体温过低、肌肉痉挛、癫痫发作及恢复延迟等,可能会使麻醉管理复杂化。全面的麻醉前评估有助于实现更好的术中及术后护理。术后镇痛很重要,尤其是在骨科手术中,其目的是缓解疼痛。本综述重点介绍了脑瘫患儿的临床表现以及此类患儿接受各种手术时的麻醉注意事项。