Perioperative Anesthesia Management and Mortality Predictors in Pediatric Patients Undergoing Craniotomy for Cranial Tumors

Year 2025, Volume: 7 Issue: 2, 333 - 338, 09.05.2025

Hülya Tosun Söner , Abdurrahman Arpa

https://doi.org/10.37990/medr.1621860

Abstract

Aim: Studies investigating the effects of perioperative anesthesia management on outcomes in patients undergoing craniotomy for pediatric intracranial tumors are limited in the literature. Our aim in this study was to investigate the effects of perioperative anesthesia management on mortality. Secondly, other mortality predictors were investigated.
Material and Method: A total of 165 patients aged <18 years who underwent craniotomy due to intracranial tumor in our hospital were included in the retrospective study between 01/2018 and 09/2024. Patients were divided into two groups according to the intraoperative anesthetic agents used. There were 58 patients in the sevoflurane group and 107 patients in the remifentanil and propofol groups. The primary endpoint was in-hospital mortality.
Results: In the sevoflurane group, the mean age (2.5 [3] vs. 7 [8], p<0.001) and body weight (15 [13] vs. 25 [8], p<0.001) of the patients were lower. Sevoflurane was the preferred anesthetic agent instead of remifentanil in the younger age group. Therefore, the perioperative vital signs of the patients also differed at a statistically significant level (p<0.05 for each). In the univariable logistic regression analyses; weight (OR=0.866, 95% CI=0.771-0.971, p=0.014), blood transfusion (OR=13.143, 95% CI=1.624-106.333, p=0.016), need for inotropes (OR=19.125, 95% CI=2.378-153.835, p=0.006), and comorbid diseases (OR=4.681, 95% CI=1.080-20.297, p=0.039), were parameters associated with mortality.
Conclusion: Our study found no link between perioperative anesthesia management and in-hospital mortality in pediatric patients who underwent craniotomy for intracranial tumors. However, low body weight, comorbidities, intraoperative blood transfusion, and inotropic support were associated with in-hospital mortality. Our study may help clinicians assess perioperative risk for patients who planned craniotomy.

Keywords

Pediatric anesthesia , craniotomy , mortality

Ethical Statement

Ethical approval was obtained from the ethics committee of Dicle University Faculty of Medicine for the study (295-16/10/2024). Our study was conducted in accordance with the principles of the Helsinki Declaration.

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