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J Pediatr Rehabil Med ; 15(1): 3-11, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35275572

RESUMEN

PURPOSE: The purpose of this study is to describe the efficacy and adverse events of neuraxial anesthesia for post-operative pain control in non-ambulatory children with cerebral palsy with pre-existing intrathecal baclofen (ITB) pumps undergoing hip reconstructive or palliative surgery. METHODS: Twelve children (mean age 11.25 years) were included in the study with the following neuraxial anesthesia methods: indwelling epidural catheter (8 patients), neuraxial opioids administered through the side port of the ITB pump (3 patients), and single injection spinal anesthetic (1 patient). Observational pain scores and opioid requirements were quantified for all patients. RESULTS: There were no ITB pump or surgical complications at a mean follow-up of 2.2 years. The average length of stay was 6 days. Patients had good post-operative pain control with a mean observational pain score of 0.7 and mean morphine equivalent use of 0.26mg/kg/day. Four patients required anti-emetics to control nausea and three patients had urinary retention requiring repeat catheterization, but all medical complications resolved prior to discharge. CONCLUSION: Neuraxial anesthesia can effectively control post-operative pain in children with a pre-existing ITB pump. Utilizing the side port of the ITB pump for administration of neuraxial opioids is an option when epidural or spinal anesthesia is not possible.


Asunto(s)
Anestesia , Parálisis Cerebral , Relajantes Musculares Centrales , Baclofeno , Parálisis Cerebral/complicaciones , Niño , Humanos , Bombas de Infusión Implantables/efectos adversos , Relajantes Musculares Centrales/uso terapéutico , Espasticidad Muscular/complicaciones , Espasticidad Muscular/tratamiento farmacológico , Dolor Postoperatorio/inducido químicamente , Dolor Postoperatorio/complicaciones , Dolor Postoperatorio/tratamiento farmacológico , Estudios Retrospectivos
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