Clinical Results of Sevoflurane Inhalation Anesthesia for Botulinum Neurotoxin Treatment in Children with Cerebral Palsy

Abstract

Objective: The botulinum neurotoxin type A (BoNT-A) intramuscular injection is a safe and reliable method to treat increased spasticity in spastic cerebral palsy (CP). Although BNT-A injections may be administered under local anesthesia, many clinicians prefer injections under general anesthesia in the operating room, especially for children. The purpose of the present study was to evaluate the safety and efficacy of administering BNT-A injections to children with spastic CP under sevoflurane mask anesthesia. Materials and Methods: Files of 61 children with CP who received 191 BoNT-A injections under sevoflurane mask anesthesia were analyzed retrospectively. The time from the beginning of anesthesia to the end of the procedure was recorded. The BNT-A dose per muscle was 3–6 IU/kg body weight for lower extremity muscles and 1–3 IU/kg body weight for upper extremity muscles. Results: The mean age of the children was 42 months. The mean procedure time was 15 min. There were no complications related to anesthesia or the BTN-A injection procedure. Conclusion: BTN-A injections in children with spastic CP may be safely and effectively administered under sevoflurane mask anesthesia without any procedural or anesthetic complications.

Keywords

• Botulinum toxin
• cerebral palsy
• inhalation anesthesia
• sevoflurane

Serebral Palsili Çocuklara Sevofluran İnhalasyon Anestezisi Altında Botulinum Toksin Uygulamalarında Klinik Sonuçlarımız

Abstract

Amaç: Botulinum nörotoksini (BoNT-A) intramusküler enjeksiyonu, serebral palside (CP) görülen spastisitelerin tedavisinde kullanımı güvenli ve güvenilir olan bir araçtır. Lokal anestezi altında uygulaması yapılabilse de çoğu klinisyen, özellikle çocuk hastalar için, uygulamaların ameliyathanede genel anestezi altında yapılmasını tercih etmektedir. Bu çalışmanın amacı, CP tanılı çocuklarda BoNT-A enjeksiyonunlarının maske ile sevofluran kullanılarak uygulanan inhalasyon anestezisi altında yapılmasının güvenliğini ve etkinliğini değerlendirmektir. Gereç ve Yöntemler: Sevofluran kullanılarak maske ile inhalasyon anestezi altında BoNT-A enjeksiyonu yapılmış 61 çocuğun dosyası retrospektif olarak incelenmiştir. Anestezi işleminin başlamasından prosedürün sonuna kadar olan süreler kaydedilerek değerlendirildi. Kas başına BoNT-A dozu her bir kas için alt ekstremitede 3-6 IU/kg, üst ekstremitede için 1-3 IU/kg olarak uygulanmıştır. Bulgular: Hastaların ortalama yaşı 42 ay iken ortalama işlem süresi 15 dakika idi. Hastalarda anestezi işlemi ya da BoNT-A uygulamasına bağlı herhangi bir komplikasyon yaşanmamıştır. Sonuç: Bu çalışmada, CP tanılı çocuklarda yapılan BoNT-A enjeksiyonlarının sevofluran kullanılarak genel anestezi altında uygulanmasının güvenli ve etkin bir yöntem olduğu gösterilmiştir.

Keywords

• Botulinum toksin
• serebral palsi
• inhalasyon anestezisi
• sevofluran

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