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Child's Nervous System

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01.08.2006 | Special Annual Issue

Anesthesiological and intensive care considerations in children undergoing extensive cerebral excision procedure for congenital epileptogenic lesions

verfasst von: D. Pietrini, F. Zanghi, A. Pusateri, F. Tosi, S. Pulitanò, M. Piastra

Erschienen in: Child's Nervous System | Ausgabe 8/2006

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Abstract

Introduction

Epilepsy is a relatively common condition in childhood with a generally favorable prognosis of the affected population. Nevertheless, a significant minority of the treated children do not respond to the medical treatment so that surgical treatment is necessary. While minor surgical procedures have a negligible incidence of mortality, major ones may carry a significant risk of perioperative complications. The leading cause of mortality is represented by hemorrhagic derangements after high intraoperative and postoperative blood loss, mostly in very young patients. Therefore, restoration of euvolemia, detection and correction of related bleeding disorders represent the major concern for pediatric neuroanesthesiologists and intensivists throughout the perioperative period. The present report is focused on the anesthesia and intensive care management of the surgical epileptic patient.

Conclusion

Authors recommend that these high-risk procedures should be performed in highly experienced centers where pediatric neurosurgery is performed daily.

Abrahams JM, Torchia MB, McGarvey M, Putt M, Baranov D, Sinson GT (2002) Perioperative assessment of coagulability in neurosurgical patients using thromboelastography. Surg Neurol 58:5–12PubMedCrossRef

Alderson PJ, Burrows FA, Stemp LI, Holtby HM (1993) Use of ultrasound to evaluate internal jugular vein anatomy and to facilitate central venous cannulation in paediatric patients. Br J Anaesth 70:145–148PubMedCrossRef

Artru AA, Momota T (2000) Rate of CSF formation and resistance to reabsorption of CGS during sevoflurane or remifentanil in rabbits. J Neurosurg Anesthesiol 12:37–43PubMedCrossRef

ASA (1996) Practice guidelines for blood component therapy. A report by the American Society of Anesthesiologists Task Force on blood component therapy. Anesthesiology 84(3):732–746CrossRef

Bjorkild E, Storm-Mathisen J, Storm E, Prydz H (1977) Localization of tissue thromboplastin in human brain. Thromb Haemost 37:92–97

Bosman C, Boldrini R, Dimitri L, Di Rocco C, Corsi A (1996) Hemimegalencephaly. Histological, immunohistochemical, ultrastructural and cytofluorimetric study of six patients. Childs Nerv Syst 12:765–775PubMedCrossRef

Bourgoin A, Albanese J, Wereszczynski N, Charbit M, Vialet R, Martin C (2003) Safety of sedation with ketamine in severe head injured patients: comparison with sufentanil. Crit Care Med 31:711–717PubMedCrossRef

Bourgoin A, Albanese J, Leone M, Sampol-Manos E, Viviand X, Martin C (2005) Effects of sufentanil or ketamine administered in target-controlled infusion on the cerebral hemodynamics of severely brain-injured patients. Crit Care Med 33(5):1109–1113PubMedCrossRef

Brandom BW, Fine GF (2002) Neuromuscular blocking drugs in pediatric anesthesia. Anesthesiol Clin North America 20(1):45–48PubMedCrossRef

10.

Brian JE Jr, Deshpande JK, McPherson RW (1990) Management of cerebral hemispherectomy in children. J Clin Anesth 2:91–95PubMedCrossRef

11.

British Committee for Standards in Haematology, Blood transfusion Task Force (2001) Guidelines for the clinical use of red cell transfusion. Br J Haematol 113:24–31CrossRef

12.

British Committee for Standards in Haematology, Blood transfusion Task Force (2003) Guidelines for the use of platelet transfusions. Br J Haematol 122:10–23CrossRef

13.

British Committee for Standards in Haematology, Blood transfusion Task Force (2004) Guidelines for the use of fresh frozen plasma, cryoprecipitate, and cryosupernatant. Br J Haematol 126:11–28CrossRef

14.

Brown DL, Morgenstern LB (2005) Stopping the bleeding in intracerebral hemorrhage. N Engl J Med 352(8):828–830PubMedCrossRef

15.

Carson BS, Javedan SP, Freeman JM, Vining EPG, Zuckerberg AL, Lauer JA, Guarnieri M (1996) Hemispherectomy: a hemidecortication approach and review of 52 cases. J Neurosurg 84:903–911PubMedCrossRef

16.

Constant I, Seeman R, Murat I (2005) Sevoflurane and epileptiform EEG changes. Paediatr Anaesth 15:266–274PubMedCrossRef

17.

Crosby ET (1992) Perioperative haemotherapy: I. Indications for blood component transfusion. Can J Anaesth 39(7):695–707PubMed

18.

D’Errico C, Shayevitz J, Martindale S (1996) The efficacy and cost of aprotinin in children undergoing reoperative open heart surgery. Anesth Analg 83:1193–1199PubMedCrossRef

19.

Di Rocco C, Iannelli A (2000) Hemimegalencephaly and intractable epilepsy: complications of hemispherectomy and their correlation with the surgical technique. A report on 15 cases. Pediatr Neurosurg 33(4):198–207PubMedCrossRef

20.

Faberowski LW, Black S, Mickle JP (1999) Blood loss and transfusion practice in the perioperative management of craniosynostosis repair. J Neurosurg Anesthesiol 3:167–172CrossRef

21.

Giroux JD, Finel E, Soupre D, Sizun J, Alix D, de Parscau L (1996) Traumatismes craniens graves du nouveau-né et du nourisson: particularitès physiopathologiques et thérapeutiques. Arch Pediatr 3(5):473–479PubMedCrossRef

22.

Goobie SM, Soriano SG, Zurakowski D, McGowan FX, Rockoff MA (2001) Hemostatic changes in pediatric neurosurgical patients as evaluated by thromboelastograph. Anesth Analg 93:887–892PubMedCrossRef

23.

Griffiths PD, Welch RJ, Gardner-Medwin D (1994) The radiological features of hemimegalencephaly including three cases associated with proteus syndrome. Neuropediatrics 25:140–144PubMed

24.

Greenwald BM, Ghajar J, Notterman DA (1995) Critical care of children with acute brain injury. Adv Pediatr 42:47–89PubMed

25.

Hans P, Martin C (1994) La sédation du traumatisé cranien. Cah Anesthesiol 42(4):521–524PubMed

26.

HayashiY, Uchida O, Takaki O, Onihshi Y, Nakajima T, Kataoka H, Kuro M (1992) Internal jugular vein catheterization in infants undergoing cardiovascular surgery: an analysis of the factors influencing successful catheterization. Anesth Analg 74:668–693

27.

Heesen M, Winking M, Kemkes-Matthes B, Deinsberger W, Dietrich GV, Matthes KJ, Hempelman G (1997) What the neurosurgeon needs to know about the coagulation system. Surg Neurol 47:32–34PubMedCrossRef

28.

Himmelseher S, Pfenninger E, Werner C (2001) Intraoperative monitoring in neuroanesthesia: a national comparison between two surveys in Germany in 1991 and 1997. Anesth Analg 92:166–171PubMedCrossRef

29.

Hind D, Calvert N, Mc Williams R, Davidson A, Paisley S, Beverly C, Thomas S (2003) Ultrasonic locating devices for central venous cannulation: meta-analysis. BMJ 327:361–364PubMedCrossRef

30.

Hormann C, Kolbitsch C, Benzer A (1997) The role of sevoflurane in neuroanesthesia practice. Acta Anaesthesiol Scand Suppl 111:150–151

31.

Huang PS, Koo KE (1990–1991) Diffuse intravascular coagulation associated with brain tumor surgery in children. Pediatr Neurosurg 16:43–47CrossRef

32.

Karsli C, Luginbuhel I, Farrar M, Bissonnette B (2003) Cerebrovascular carbon dioxide reactivity in children anesthetized with propofol. Paediatr Anaesth 13:26–31PubMedCrossRef

33.

Kearney RA, Rosales JK, Howes WJ (1989) Craniosynostosis: an assessment of blood loss and transfusion practices. Can J Anaesth 36(4):473–477PubMed

34.

Kearney TJ, Bentt L, Grode M, Lee S, Hiatt JR, Shabot MM (1992) Coagulopathy and cathecolamines in severe head injury. J Trauma 32:608–612PubMedCrossRef

35.

Komatsu H, Taie S, Endo S, Fukuda K, Ueki M, Nokaya J, Ogli K (1994) Electrical seizure during sevoflurane anesthesia in two pediatric patients with epilepsy. Anesthesiology 81:1535–1537PubMedCrossRef

36.

Levi M, ten Cate H, van der Poll T (2002) Endothelium Interface between coagulation and inflammation. Crit Care Med 30(5):S220–S224PubMedCrossRef

37.

Mannucci PM, AB Federici AB, G Sirchia G (1982) Hemostasis testing during massive blood replacement: a study of 172 cases. Vox Sang 42:113–123PubMedCrossRef

38.

Morray JP, Geiduschek JM, Ramamoorthy C, Haberkern CM, Hackel H, Caplan RA, Domino KB, Posner K, Cheney FW (2000) Anesthesia-related cardiac arrest in children: initial findings of the Pediatric Perioperative Cardiac Arrest (POCA) Registry. Anesthesiology 93:6–14PubMedCrossRef

39.

Oppenheimer DR, Griffith HB (1996) Persistent intracranial bleeding as a complication of hemispherectomy. J Neurol Neurosurg Psychiatry 29:229–240CrossRef

40.

Peacock WJ, Wehby-Grant MC, Shields WD, Shewmon DA, Chugani HT, Sankar R, Vinters HV (1996) Hemispherectomy for intractable seizures in children: a report of 58 cases. Childs Nerv Syst 12:376–384PubMedCrossRef

41.

Piastra M, Pietrini D, Caresta E, Chiaretti A, Viola L, Cota F, Pusateri A, Polidori G, Di Rocco C (2004) Hemispherectomy procedures in children: haematological issues. Childs Nerv Syst 20:453–458PubMedCrossRef

42.

Piastra M, De Carolis MP, Tempera A, Caresta E, Polidori G, Chiaretti A, Pietrini D, Ruggiero A, Caldarelli M, Di Rocco C (2004) Massive congenital intracranial teratoma. Perioperative coagulation impairment. J Pediatr Hematol Oncol 26(11):712–717PubMedCrossRef

43.

Pietrini D, Ciano F, Forte E, Pusateri A, Valenti M, Zanghi F, Chiaretti A, Piastra M, Tamburrini G, Caldarelli M (2004) Massive blood loss during removal of congenital choroid plexus tumors. J Neurosurg Anesthesiol 16(3):259–262CrossRef

44.

Pietrini D, Savioli A, Grossetti R, Barbieri MA, Buscalferri A, Calamandrei M, Chiaretti A, David A, Di Rocco C, Dusio MP, Febi G, Gallini C, Giordano F, Girasole V, Lampugnani E, Laviani Mancinelli R, Levati A, Mazza C, Meneghini L, Paccagnella F, Piastra M, Procaccini E, Pusateri A, Scielzo R, Stofella G, Stoppa F, Tamburrini G, Testoni C, Tumolo M, Velardi F, Zei E, Latronico N (2004) SIAARTI-SARNePI guidelines for the management of severe pediatric head injury. Minerva Anestesiol 70:549–604PubMed

45.

Polderman KH, Girbes ARJ (2002) Central venous catheter use. Part 1: mechanical complications. Intensive Care Med 28:1–17PubMedCrossRef

46.

Rigby-Jones AE, Nolan JA, Priston MJ, Wright PMC, Sneyd JR, Wolf AR (2002) Pharmacokinetics of propofol infusion in critical ill neonates, infants and children in an intensive care unit. Anesthesiology 97:1393–1400PubMedCrossRef

47.

Ruttmann TG (2002) Haemodilution enhances coagulation. Br J Anaesth 88:470–472PubMedCrossRef

48.

Sawaya R, Kornblith PL (1987). Brain tumors and thromboembolic complications. Surg Neurol 28:163PubMedCrossRef

49.

Shurin S, Rekate H (1981) Disseminated intravascular coagulation as a complication of ventricular catheter placement. Case report. J Neurosurg 54(2):264–267PubMed

50.

Skippen PW (1999) Trauma: cranial, spinal and multiple. In: Macnab A, Macrae D, Henning R editors. Care of the critically ill child. Churchill Livingstone, Oxford, pp 83–102

51.

Soriano SG, Eldredge EA, Rockoff MA (2002) Pediatric neuroanesthesia. Anesthesiol Clin North America 20:389–404PubMedCrossRef

52.

Spitzfaden AC, Jimenez DF, Tobias JD (1993) Propofol for sedation and control of intracranial pressure in children. Pediatr Neurosurg 3:194–200

53.

Taha JM, Crone KR, Berger TS (1994) The role of hemispherectomy in the treatment of holohemispheric hemimegaloencephaly. J Neurosurg 81:37–42PubMedCrossRef

54.

Trabold F, Meyer P, Orliaguet G (2002) Les traumatismes craniens du nourisson et du petit enfant: prise en charge initiale. Ann Fr Anesth Reanim 21:141–147PubMedCrossRef

55.

Vakkuri A, Yli-Hankala A, Sarkela M, Lindgren L, Mennander S, Korttila K, Saarnivara L, Jantti V (2001) Sevoflurane mask induction of anesthesia is associated with epileptiform EEG in children. Acta Anaesthesiol Scand 45:805–814PubMedCrossRef

56.

Ventureyra ECG, Higgins MJ (1993) Complication of epilepsy surgery in children and adolescents. Pediatr Neurosurg 19:40–56PubMedCrossRef

57.

Verghese ST, McGill WA, Patel RI, Sell JE, Migdley FM, Ruttiman UE (1999) Ultrasound-guided internal jugular venous cannulation in infants. Anesthesiology 91(1):71–77PubMedCrossRef

58.

Vining EPG, Freeman GM, Pillas DJ, Uematsu S, Carson BS, Brandt J, Boatman D, Pulsifer MB, Zuckerberg A (1997) Why would you remove half a brain? The outcome of 58 children after hemispherectomy—The Johns Hopkins experience: 1968 to 1996. Pediatrics 100(2):163–171PubMedCrossRef

59.

Wilson PJE (1970) Cerebral hemispherectomy for infantile hemiplegia: a report of 50 cases. Brain 93:147–180PubMedCrossRef

60.

Wong TC, Ong BC, Ang C, Chee HL (2003) Anesthetic management for a five-day separation of craniopagus twins. Anesth Analg 97:999–1002PubMedCrossRef

61.

Woodforth IJ, Hicks RG, Crawford MR, Stephen JP, Burke DJ (1997) Electroencephalographic evidence of seizure activity under deep sevoflurane anesthesia in a nonepileptic patient. Anesthesiology 87:1579–1582PubMedCrossRef

Titel: Anesthesiological and intensive care considerations in children undergoing extensive cerebral excision procedure for congenital epileptogenic lesions
verfasst von: D. Pietrini
F. Zanghi
A. Pusateri
F. Tosi
S. Pulitanò
M. Piastra
Publikationsdatum: 01.08.2006
Verlag: Springer-Verlag
Erschienen in: Child's Nervous System / Ausgabe 8/2006
Print ISSN: 0256-7040
Elektronische ISSN: 1433-0350
DOI: https://doi.org/10.1007/s00381-006-0153-0

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