Year : 2013 | Volume
: 29 | Issue : 3 | Page : 323--327
Perioperative concerns in pediatric patients undergoing different types of scoliosis correction surgery: A retrospective observational study
Anjolie Chhabra1, Mahesh Kumar Arora1, Dalim Kumar Baidya1, Praveen Talawar1, Preet Mohinder Singh1, Arvind Jayswal2
1 Department of Anaesthesiology and Intensive Care, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
2 Department of Orthopaedics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
Background: Advances in scoliosis surgery have now made it possible for younger patients to be taken up for scoliosis correction.
Objectives: To ascertain the patient profile, perioperative complications and need for intensive care management in children undergoing posterior fusion and instrumentation (PF), anterior release (AR), and growth rod (GR) insertion surgery.
Patients and Methods: After taking parental consent, data were collected retrospectively for 33 patients who underwent 37 procedures (four patients had both anterior and posterior procedures) on 2 days of the week mainly from August 2008 to February 2010 at a tertiary care institution.
Results: Children undergoing GR surgery were younger (8.1 ± 2.1 years) than patients undergoing AR (12.9 ± 1.7 years) or posterior fusion (14.2 ± 2.2 years). AR children had a significantly higher Cobb«SQ»s angle and more rigid curves. (P = 0.057) Associated congenital abnormalities especially neurological were commoner in the GR children. Surgical duration and blood loss was significantly more for PF (2207.5 ± 1224.13 ml) than GR (456 ± 337.5 ml), or AR (642.85 ± 304.72 ml), (P = 0.0002). PF patients needed Intensive care unit (ICU) care mainly due to the blood loss and prolonged surgery (35%). AR performed via thoracotomy was associated with the need for mechanical ventilation in 28.6%. The GR patients had major intraoperative hemodynamic events and 20% needed ICU care.
Conclusions: Post-operative ventilation may be required in 20-35% patients undergoing procedures for scoliosis correction. Despite GR insertion involving lesser blood loss; younger age, congenital abnormalities, positioning, and surgical manipulation resulted in life threatening events in these patients.
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|How to cite this article:|
Chhabra A, Arora MK, Baidya DK, Talawar P, Singh PM, Jayswal A. Perioperative concerns in pediatric patients undergoing different types of scoliosis correction surgery: A retrospective observational study.J Anaesthesiol Clin Pharmacol 2013;29:323-327
|How to cite this URL:|
Chhabra A, Arora MK, Baidya DK, Talawar P, Singh PM, Jayswal A. Perioperative concerns in pediatric patients undergoing different types of scoliosis correction surgery: A retrospective observational study. J Anaesthesiol Clin Pharmacol [serial online] 2013 [cited 2019 Aug 18 ];29:323-327
Available from: http://www.joacp.org/article.asp?issn=0970-9185;year=2013;volume=29;issue=3;spage=323;epage=327;aulast=Chhabra;type=0