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CC BY-NC-ND 4.0 · J Neuroanaesth Crit Care 2022; 09(01): 029-034
DOI: 10.1055/s-0041-1740203
Original Article

Comparison of Perioperative Anesthetic Concerns in Simple and Complex Craniosynostosis Cases: A Retrospective Study

Gokuldas Menon 
1   Department of Anaesthesiology and Critical Care, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India
,
Mathew George 
1   Department of Anaesthesiology and Critical Care, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India
,
Pawan Kumar 
1   Department of Anaesthesiology and Critical Care, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India
,
Shalini M. Nair
1   Department of Anaesthesiology and Critical Care, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India
,
Suhas Udayakumaran
2   Department of Neurosurgery, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India
,
Arjun Krishnadas
3   Department of Cleft and Craniomaxillofacial Surgery, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India
,
Pramod Subash
3   Department of Cleft and Craniomaxillofacial Surgery, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India
,
Anu Vasudevan
4   Department of Biostatistics, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India
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Abstract

Background We compared intraoperative and postoperative anesthetic parameters between simple (S-single suture) and complex (C-more than one suture) craniosynostosis cases.

Materials and Methods Data was collected from a retrospective review of anesthetic and postoperative records of patients who underwent craniosynostosis correction surgery between April 2014 and August 2019. Pearson’s chi-square and independent sample t-tests were used for analysis.

Results We analyzed data of 98 patients (S-simple craniosynostosis: 40 and C-complex craniosynostosis: 58). Statistically significant differences between simple and complex cases were seen only in the incidence of difficult airway, failed extubation, and requirement of postoperative ventilation. Massive blood loss (S: 23.21 mL/kg; C: 22.71 mL/kg) and difficult airway (S: 2.04%; C: 19.39%) were the most common intraoperative adverse events encountered. Metabolic abnormalities, hemodynamic instability, and hypothermia occurred in few patients. The most common postoperative issue was pyrexia (S: 15.31%; C: 17.35%). Anemia and coagulopathy needing transfusion of blood products and vitamin K injection were seen in a significant number of cases. Three nonsyndromic patients developed seizures.

Conclusion The incidence of difficult airway and failed extubation with postoperative ventilation is more frequent following surgery for complex craniosynostosis than simple craniosynostosis. Complications secondary to blood loss and airway issues were the primary cause of morbidity and mortality. A staged approach to surgical management resulted in decreased surgical blood loss among the children with complex craniosynostosis.

Keywords

anesthesia - craniosynostosis - coagulopathy - syndrome - simple - complex - complications


Publikationsverlauf

Artikel online veröffentlicht:
22. Februar 2022

© 2022. Indian Society of Neuroanaesthesiology and Critical Care. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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