General anesthesia use in phenol intramuscular neurolysis in young children with spasticity.

This study reviews a nearly three-year experience of intramuscular neurolysis in children with spasticity. Thirteen children aged 3 to 11 years received general anesthesia during 16 procedures. Ten were cerebral palsy patients, one a congenital hydrocephalic, one a familial spastic paraplegic, and one a brain-injured child. Types of preoperative medications, induction and maintenance anesthetic agents are described, with indications for the particular choices of each type of drug. The principal and side effects of these agents during and after the 16 procedures are summarized. A combination of agents such as chloral hydrate; atropine if endotracheal intubation is necessary; pentothal, halothane, or cyclopropane for induction, and halothane-nitrous oxide for maintenance is our current choice of drugs to produce a light surgical plane of anesthesia. Advantages and disadvantages of the operating room method are considered. An overnight hospital stay was sufficient for all but two children, who required an additional evening of observation as the result of anesthetic side effects. No major complications were encountered in any of these elective procedures. The presence of a pediatric anesthesiologist during the procedure is perhaps to most reassuring aspect of the operating room-general anesthesia method.