Anesthesia and Postoperative Outcome in Pediatric Cranial Surgery: A Retrospective Single Center Study

Abstract

Background: Perioperative patient monitoring and follow-up is very important to minimize morbidity and mortality in pediatric neurosurgical interventions. In this study, it was aimed to evaluate the perioperative anesthesia management by examining the findings of the pediatric patients who underwent cranial surgery along with to examine the effects of hemorrhagic surgical procedures, which play an active role in morbidity, both intraoperatively and postoperatively, including hospitalization in intensive care unit. Methods: Follow-up files of 303 pediatric patients between the ages of 0-18, who were taken to cranial operation, between 2015-2018 years evaluated as retrospectively. Results: A total of 303 children 199 (65.7%) ≤1 year old, 104 (34.3%) >1 year old who underwent pediatric neurosurgery were included in our study. It was determined that the most frequently performed operation was shunting due to hydrocephalus and craniosynostosis. In subanalysis, in craniosynostosis operations performed frequently in infants aged ≤1, it was observed that bleeding amount was as much as subdural and epidural hematoma operations performed in children >1 year old (181ml and 196 ml, p =0.444, respectively). There was no difference between groups in intensive care unit admission. Conclusıons: We think that in pediatric neurosurgery patients' perioperative anesthesia management, it is important to closely monitor the vital signs of patients, to record complications and blood transfusions in detail. We believe that due to the more aggressive duration of hypotensive processes, more attention should be paid to morbidity and mortality, especially in cases of craniosynostosis.

Keywords

• craniosynostosis
• hydrocephalus
• neurosurgery
• pediatric
• perioperative anesthesia management.

Pediatrik Kraniyal Cerrahide Anestezi ve Postoperatif Sonuçların Değerlendirilmesi: Retrospektif Tek Merkezli Çalışma

Abstract

Amaç: Pediyatrik nöroşirurjik cerrahi girişimlerde morbidite ve mortaliteyi en aza indirgemek için perioperatif hasta monitörizasyonu oldukça önemlidir. Bu çalışmada, kraniyal cerrahi uygulanan çocuk hastaların verileri incelenerek perioperatif anestezi yönetiminin değerlendirilmesi beraberinde morbiditede etkin rol oynayan hemorajik cerrahi prosedürlerin hem intraoperatif hem de yoğun bakım ünitesinde yatış sürecini de içeren postoperatif dönemdeki etkilerinin incelenmesi amaçlandı. Gereç ve Yöntem: 2015-2018 yılları arasında kraniyal cerrahi nedeni ile operasyona alınmış 0-18 yaş arası, toplam 303 çocuk hastanın verileri retrospektif olarak değerlendirildi. Bulgular: Çalışmamıza, pediatrik kraniyal cerrahi geçirmiş 199'u (%65,7) ≤1 yaş, 104'ü (%34,3) >1 yaşında olmak üzere toplam 303 çocuk dahil edildi. En sık hidrosefali nedeniyle şant ve kraniyosinostoz operasyonlarının olduğu belirlendi. Alt analizde ≤1 yaş bebeklerde sık uygulanan kraniyosinostoz ameliyatlarında kanama miktarının >1 yaş çocuklarda yapılan subdural ve epidural hematom ameliyatlarında ki kadar fazla olduğu görüldü (sırasıyla 181ml ve 196ml, p=0,444). Yoğun bakıma yatışta gruplar arasında fark yoktu. Sonuç: Pediatrik beyin cerrahisi hastalarının perioperatif anestezi yönetiminde hastaların vital bulgularının yakından izlenmesi, komplikasyonların ve kan transfüzyonlarının detaylı olarak kayıt altına alınmasının önemli olduğunu düşünüyoruz. Hipotansif süreçlerin daha agresif seyir göstermesi nedeniyle, özellikle kraniyosinostoz vakalarında morbidite ve mortalitenin önlenmesi açısından daha fazla dikkat edilmesi gerektiğine inanıyoruz.

Keywords

• hidrosefali
• kraniyal cerrahi
• kraniyosinostozis
• pediatrik anestezi
• perioperatif anestezi yönetimi

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