Title: Anaesthesia for Neurosurgical Procedures in Paediatric Patients at Kamineni Institute of Medical Sciences

Authors: Dr Sujay, Dr Santhosh Kumar Nangunuri

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i11.86

Abstract

Recent advances in neurosurgery, neuromonitoring and neurointensive care have dramatically improved the outcome in patients affected by surgical lesions of central nervous system (CNS). Although most of these techniques were applied first in the adult population, paediatric patients present a set of inherent challenges because of their developing and maturing neurological and physiological status, apart from the CNS disease process. To provide optimal neuroanaesthesia care, the anaesthesiologist must have the knowledge of basic neurophysiology of developing brain and effects of various drugs on cerebral haemodynamics apart from the specialised training on paediatric neuroanaesthesia. This article highlights on the perioperative management of paediatric neurosurgical patients.

 

References

  1. Singh D, Rath GP, Dash HH, Bithal PK. Sevoflurane provides better recovery as compared with isoflurane in children undergoing spinal surgery. J Neurosurg Anesthesiol 2009;21:202-6. [PUBMED]   
  2. Singh D, Rath GP, Dash HH, Bithal PK. Anesthetic concerns and perioperative complications in repair of myelomenin-gocele: A retrospective review of 135 cases. J Neurosurg Anesthesiol 2010;22: 11-5. [PUBMED]   
  3. Rath GP, Bithal PK, Chaturvedi A, Dash HH. Complications related to positioning in posterior fossa craniectomy. J Clin Neurosci 2007;14:520-5. [PUBMED]   
  4. Scheingraber S, Rehm M, Sehmisch C, Finsterer U. Rapid saline infusion produces hyperchloremic acidosis in patients undergoing gynecologic surgery [see comments]. Anesthesiology 1999;90:1265-70. [PUBMED]   
  5. Grinkeviciute D, Kevalas R. Induced mild hypothermia in children after brain injury. Rev Neurosci 2009;20:261-6. [PUBMED]
  6. Newfield P, Feld LH, Hamid RK. Induced mild hypothermia in children after brain injury. In: Newfield P, Cottrell JE, editors. Philadelphia: Lippincott Williums and Wilkins; 2007. p. 256-77.
  7. Singh GP, Prabhakar H, Bithal PK, Dash HH. A retrospective analysis of periope-rative complications during intracranial neuroendoscopic procedures: Our institutional experience. Neurol India 2011;59:874-8.
  8. Prabhakar H, Rath GP, Bithal PK, Chouhan RS. Intracranial pressure and haemodynamic changes during the tunnelling phase of ventriculoperitoneal shunt insertion. Eur J Anaesthesiol 2005;22:947-50. [PUBMED]   
  9. Rath GP, Prabhakar H, Bithal PK, Dash HH, Narang KS, Kalaivani M. Effects of butorphanol and fentanyl on cerebral pressures and cardiovascular hemodyn-amics during tunneling phase for ventriculoperitoneal shunt insertion. Middle East J Anesthesiol 2008;19:1041-53. [PUBMED]   
  10. Alfery DD, Shapiro HM, Gagnon RL. Cardiac arrest following rapid drainage of cerebrospinal fluid in a patient with hydrocephalus. Anesthesiology 1980;52:443-4. [PUBMED]   
  11. Faberowski LW, Black S, Mickle JP. Incidence of venous air embolism during craniectomy for craniosynostosis repair. Anesthesiolgy 2000;92:20-3. [PUBMED]   
  12. Goyal K, Chaturvedi A, Prabhakar H. Factors affecting the outcome of patients undergoing corrective surgery for craniosynostosis: A retrospective analysis of 95 cases. Neurol India 2011;59:823-8.
  13. Soriano SG, Eldredge EA, Rockoff MA. Pediatric neuroanesthesia. Anesthesiology Clin N Am 2002;20:389-404. [PUBMED]   
  14. Ghiarardello S, Hopper N, Albanese A, Maghnie M. Diabetes insipidus in craniopharyngioma: Postoperative manag-ement of water and electrolyte disorders. J Pediatr Endocrinol Metab 2006;19Suppl 1:413-21.
  15. Rath GP, Bithal PK, Chaturvedi A. Atypical presentations in Chiari II malformation. Pediatr Neurosurg 2006;42: 379-82. [PUBMED]   
  16. Kennedy C, Sokoloff L. An adaptation of the nitrous oxide method to the study of the cerebral circulation in children; normal values for cerebral blood flow and cerebral metabolic rate in childhood. J Clin Invest 1957;36:1130-7. [PUBMED]   
  17. Chiron C, Raynaud C, Maziére B, Zilbovicius M, Laflamme L, Masure MC, et al. Changes in regional cerebral blood flow during brain maturation in children and adolescents. J Nucl Med 1992;33:696-703.
  18. Krass IS. Physiology and metabolism of brain and spinal cord. In: Newfield P, Cottrell JE, editors. Handbook of Neuroanaesthesia. Philadelphia: Lippincott Williams and Wilkins; 2007. p. 3-22.
  19. Pryds O. Control of cerebral circulation in the high-risk neonate. Ann Neurol 1991;30:321-9. [PUBMED]   
  20. Krane EJ, Phillip BM, Yeh KK, Domino KB. Anaesthesia for paediatric neurosurgery. In: Smith RM, Mototyama EK, Davis PJ, editors. Smith's Anaesthesia for Infants and Children, 7 th Edn. Philadelphia: Mosby; 2006. p. 651-84.
  21. Pollard RJ, Mickle JP. Pediatric neuroanesthesia. In: Cucchiara RF, Black S, michenfelder JD, editors. Clinical Neuroanesthesia. Newyork: Churchil Livingstone; 1998. p. 497-537.

Corresponding Author

Dr Sujay

Address: JS Hospital, 1-14-158 Balamrai 68 Sappers Lines,

Secunderabad 500003, Telangana State

PH: 09109190897, Email: This email address is being protected from spambots. You need JavaScript enabled to view it.