A retrospective analysis of anesthesiologic complications in pediatric neurosurgery.
OBJECTIVE
Different clinical and surgical factors can influence the occurrence of anesthesiologic complications in pediatric neurosurgery. Preoperative knowledge of these factors is of great importance in the application of safe anesthetics and a favorable surgical outcome. The objective was to establish the importance of clinical and surgical risk factors on the frequency of anesthesia complications in pediatric neurosurgery.


METHODS
The research, from 1996 to 2000, involved 705 children, aged from <1 year to 15 years, who underwent surgery for elective neurosurgical pathology and severe head injuries. We analysed the influence that: age, the preoperative neurologic diagnosis, the urgency of the operation, additional disorders, the surgical position, and the duration of anesthesia had on the frequency of anesthesia complications. To test the statistical relevance and to confirm the hypothesis, the Pearson's chi-square test, Mann-Whitney U-test, and univariate and multivariate logistic regressions were used.


RESULTS
Anesthesia complications (cardiovascular, respiratory, air embolism, allergic reactions) were present in 68/705 (9.6%) patients. Their frequency was statistically greater in children for whom the surgery was >240 min, who were in the sitting position and when comorbidity was evident. Neither age nor the urgency of the operation or reoperation had any significant influence on the occurrence of anesthetic complications.


CONCLUSIONS
The duration of anesthesia, the sitting position of the patient, and the presence of comorbidities significantly increase the risk of anesthesia complications in pediatric neurosurgery.
Aleksic
Valentina
V
Department of Anesthesia and Reanimation, Institute for Neurosurgery, Clinical Center of Serbia, Koste Todorovica 8, Belgrade, Serbia. valas@sezampro.yu
Radulovic
Danilo
D
Milakovic
Branko
B
Nagulic
Mirjana
M
Vucovic
Dragan
D
Antunovic
Vaso
V
Djordjevic
Momcilo
M
D000293:Adolescent; D000768:Anesthesia, General / Q000009:adverse effects*; D001927:Brain Diseases / Q000601:surgery; D001930:Brain Injuries / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D003627:Data Interpretation, Statistical; D005260:Female; D006801:Humans; D007223:Infant; D007431:Intraoperative Complications / Q000453:epidemiology*; D008297:Male; D016343:Monitoring, Intraoperative; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D012189:Retrospective Studies; D055771:Serbia / Q000453:epidemiology