title: Spinal anaesthesia for orthopaedic surgery in children with cerebral palsy: Analysis of 36 patients.
abstract: OBJECTIVE
  Cerebral palsy is one of the most common childhood neuromuscular diseases in the world. Spinal anaesthesia in children is an evolving technique with many advantages in perioperative management. The aim of this retrospective study was to provide first-hand reports of children with cerebral palsy who underwent orthopaedic surgery under spinal anaesthesia.
  
  
  METHODS
  Records of the children with cerebral palsy who underwent orthopaedic surgery under spinal anaesthesia between May 2012 and June 2013 at Selcuk University Hospital were investigated. In all patients, lumbar puncture was performed in lateral decubitus position with mask sevoflurane-nitrous oxide anaesthesia. In patients who were calm prior the spinal block, inhalation anaesthesia was terminated. In patients who were restless before the spinal block, anaesthesia was combined with light sevoflurane anaesthesia and a laryngeal mask. From anaesthesia records, the number of attempts required to complete the lumbar puncture, and the success rates of spinal anaesthesia and perioperative complications were noted. Data were expressed as numbers and percentages.
  
  
  RESULTS
  The study included 36 patients (20 girls and 16 boys). The mean age was 71 months. The rate of reaching subarachnoid space on first attempt was 86%. In all patients, spinal anaesthesia was considered successful. In 26 patients, laryngeal mask and light sevoflurane anaesthesia were required to maintain ideal surgical conditions. No major perioperative complications were observed.
  
  
  CONCLUSIONS
  Spinal anaesthesia alone or combined with light sevoflurane anaesthesia is a reliable technique with high success rates in children with cerebral palsy undergoing orthopaedic surgery.
authors: Ozkan Onal, Department of Anaesthesia and Intensive Care, Selcuk University Medical Faculty, Konya, Turkey.
authors: Ozkan
authors: O
authors: Onal
authors: Seza Apiliogullari, Department of Anaesthesia and Intensive Care, Selcuk University Medical Faculty, Konya, Turkey.
authors: Seza
authors: S
authors: Apiliogullari
authors: Ergun Gunduz, Department of Anaesthesia and Intensive Care, Selcuk University Medical Faculty, Konya, Turkey.
authors: Ergun
authors: E
authors: Gunduz
authors: Jale Bengi Celik, Department of Anaesthesia and Intensive Care, Selcuk University Medical Faculty, Konya, Turkey.
authors: Jale Bengi
authors: JB
authors: Celik
authors: Hakan Senaran, Department of Orthopaedics and Traumatology, Selcuk University Medical Faculty, Konya, Turkey.
authors: Hakan
authors: H
authors: Senaran
keywords: Cerebral palsy; Orthopaedic Surgery; Pediatric; Spinal anesthesia