title: Effect of general anesthesia in patients with cerebral palsy at the turn of the new millennium: a population-based study evaluating perioperative outcome and brief overview of anesthetic implications of this coexisting disease.
abstract: The severity of preoperative cerebral palsy appears to correlate directly with postoperative complications. The primary aim of this study was to characterize the frequency of perioperative morbidity and mortality in cerebral palsy patients undergoing anesthesia. This was accomplished by undertaking a systematic review of the Mayo Database. The risk for perioperative adverse events was 63.1% (95% confidence interval 59.8%-66.5%). However, it deserves clarification that hypothermia and clinically significant yet non-life-threatening hypotension represented the majority (80%) of these complications. When these 2 events are excluded, the rate of adverse perioperative events was 13.1% (95% confidence interval 10.8%-15.5%). Risk factors associated with increased risk included American Society of Anesthesiologists physical status score exceeding 2, history of seizures, upper airway hypotonia, general surgery procedures, and adults. Our findings are useful to counsel patients with cerebral palsy, their caregivers, and their guardians regarding the risk of general anesthesia.
authors.affiliation: Department of Anesthesiology, Mayo Clinic, Rochester, MN 55905, USA. wass.thomas@mayo.edu
authors.forename: C Thomas
authors.initials: CT
authors.lastname: Wass
authors.forename: Mary E
authors.initials: ME
authors.lastname: Warner
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Worrell
authors.forename: Julie A
authors.initials: JA
authors.lastname: Castagno
authors.forename: Melinda
authors.initials: M
authors.lastname: Howe
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Kerber
authors.forename: Jenna M
authors.initials: JM
authors.lastname: Palzkill
authors.forename: Darrell R
authors.initials: DR
authors.lastname: Schroeder
authors.forename: Gregory D
authors.initials: GD
authors.lastname: Cascino
mesh_terms: D000328:Adult; D000768:Anesthesia, General / Q000009:adverse effects*; D002547:Cerebral Palsy / Q000453:epidemiology / Q000401:mortality* / Q000601:surgery / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D018672:Community Health Planning; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D007022:Hypotension / Q000209:etiology; D008297:Male; D008305:Malignant Hyperthermia; D015999:Multivariate Analysis; D019990:Perioperative Care; D011183:Postoperative Complications; D012307:Risk Factors; D015996:Survival Rate