[Preoperative evaluation, anesthetic management and postoperative complications of athetotic type cerebral palsy patients undergoing laminoplasty].
BACKGROUND
The patients with athetotic type cerebral palsy need to have their necks fixed for preventing worsening of their symptoms during surgery. Cervical fixation with a halo vest leads to difficult tracheal intubation and possibility of aspiration. Therefore careful perioperative management is necessary, especially for respiratory complications. However, since it is difficult on the patients with cerebral palsy to perform spirogram correctly, their preoperative respiratory functions are hard to be evaluated.


METHODS
We evaluated the relationships between preoperative condition and postoperative complications in 50 athetotic type cerebral palsy patients who had undergone laminoplasty. In addition, we also compared them with non-cerebral palsy patients for laminoplasty without a halo vest.


RESULTS
The patients with cerebral palsy showed lower preoperative ADL score, severer symptoms of myelopathy, and decreased %VC in spirogram. We found all of these were related to prolonged postoperative recovery of ADL and longer hospitalization. Two patients with cerebral palsy suffered from aspiration pneumonia after operation, whereas any non-cerebral palsy patients had no remarkable complications.


CONCLUSIONS
Careful perioperative management is necessary for cerebral palsy patients undergoing laminoplasty, especially for prevention of aspiration pneumonia.
Tajima
Keiko
K
Department of Anesthesiology, Osaka Police Hospital, Osaka 543-8502.
Kita
Takashi
T
Nakano
Sonoko
S
Sasaki
Shigeta
S
D000328:Adult; D000368:Aged; D000758:Anesthesia; D002547:Cerebral Palsy / Q000601:surgery*; D002574:Cervical Vertebrae / Q000601:surgery*; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects; D007796:Laminectomy; D008297:Male; D008875:Middle Aged; D009989:Orthotic Devices / Q000009:adverse effects; D019990:Perioperative Care; D011015:Pneumonia, Aspiration / Q000209:etiology / Q000517:prevention & control; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control