[Anesthesia and perioperative management in infants with Chiari type II malformation].
From July 1991 to June 1997. 15 neonates with Chiari type II malformation were treated at our institution. Four of them required posterior fossa decompression and cervical laminectomy for hindbrain decompression. We report anesthesia and postoperative management in these four patients. They had a fetal diagnosis of hydrocephalus and was delivered by caesarean section. They underwent Ommaya reservoir placement for drainage and repair of myelomeningocele in the neonatal period. They developed respiratory depression as apneic spells or retraction with or without swallowing difficulties and underwent posterior fossa decompression and cervical laminectomy at 20-87 days of life. One patient died of asthma at the age of 2 years and 8 days and others are doing well. Patients with this malformation may develop respiratory depression such as apneic spells and vocal cord paralysis even if the intracranial pressure is well controlled and they should be monitored carefully for the signs of apnea and the compromised airway.
Nishino
H
H
Department of Anesthesiology, Osaka Medical Center.
Kinouchi
K
K
Fukumitsu
K
K
Kitamura
S
S
Takemoto
O
O
D000768:Anesthesia, General; D001049:Apnea / Q000517:prevention & control; D001139:Arnold-Chiari Malformation / Q000601:surgery*; D002675:Child, Preschool; D019299:Decompression, Surgical; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007796:Laminectomy / Q000379:methods*; D016343:Monitoring, Intraoperative; D009333:Neck; D011182:Postoperative Care; D011183:Postoperative Complications / Q000517:prevention & control