title: Perioperative complications of orthopedic surgery for lower extremity in patients with cerebral palsy.
abstract: Because complications are more common in patients with cerebral palsy (CP), surgeons and anesthesiologists must be aware of perioperative morbidity and be prepared to recognize and treat perioperative complications. This study aimed to determine the incidence of and risk factors for perioperative complications of orthopedic surgery on the lower extremities in patients with CP. We reviewed the medical records of consecutive CP patients undergoing orthopedic surgery. Medical history, anesthesia emergence time, intraoperative body temperature, heart rate, blood pressure, immediate postoperative complications, Gross Motor Function Classification System (GMFCS) level, Cormack-Lehane classification, and American Society of Anesthesiologists physical status classification were analyzed. A total of 868 patients was included. Mean age at first surgery was 11.8 (7.6) yr. The incidences of intraoperative hypothermia, absolute hypotension, and absolute bradycardia were 26.2%, 4.4%, and 20.0%, respectively. Twenty (2.3%) patients had major complications, and 35 (4.0%) patients had minor complications postoperatively. The incidences of intraoperative hypothermia, absolute hypotension, and major postoperative complications were significantly higher in patients at GMFCS levels IV and V compared with patients at GMFCS levels I to III (P<0.001). History of pneumonia was associated with intraoperative absolute hypotension and major postoperative complications (P<0.001). These results revealed that GMFCS level, patient age, hip reconstructive surgery, and history of pneumonia are associated with adverse effects on intraoperative body temperature, the cardiovascular system, and immediate postoperative complications.
authors.affiliation: Department of Orthopedic Surgery, Ewha Womans University Mokdong Hospital, Seoul, Korea.
authors.forename: Seung Yeol
authors.identifier: 0000-0003-4971-5544
authors.initials: SY
authors.lastname: Lee
authors.affiliation: Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Hye-Min
authors.identifier: 0000-0003-3545-3248
authors.initials: HM
authors.lastname: Sohn
authors.affiliation: Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Chin Youb
authors.identifier: 0000-0002-0658-4532
authors.initials: CY
authors.lastname: Chung
authors.affiliation: Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Sang-Hwan
authors.identifier: 0000-0001-5452-4166
authors.initials: SH
authors.lastname: Do
authors.affiliation: Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Kyoung Min
authors.identifier: 0000-0002-2372-7339
authors.initials: KM
authors.lastname: Lee
authors.affiliation: Biomedical Research Institute, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Soon-Sun
authors.identifier: 0000-0002-3344-1609
authors.initials: SS
authors.lastname: Kwon
authors.affiliation: Department of Orthopedic Surgery, Myongji Hospital, Goyang, Korea.
authors.forename: Ki Hyuk
authors.identifier: 0000-0002-5007-2403
authors.initials: KH
authors.lastname: Sung
authors.affiliation: Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Sun Hyung
authors.identifier: 0000-0003-2814-6346
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Moon Seok
authors.identifier: 0000-0002-2856-7522
authors.initials: MS
authors.lastname: Park
mesh_terms: D000293:Adolescent; D000328:Adult; D002547:Cerebral Palsy / Q000150:complications*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology*; D035002:Lower Extremity / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000009:adverse effects*; D011183:Postoperative Complications / Q000209:etiology*
keywords: ASA Class; Cerebral Palsy; GMFCS Level; Perioperative Complication; Single Event Multilevel Surgery
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