CASE REPORT
ANESTHETIC MANAGEMENT OF A 6-YEAR-OLD CHILD WITH CEREBRAL PALSY UNDERGOING DENTAL SURGERY

UDK: 616.31-089.5:616.831-009.11]-053.2

Kolevska S1,2, Gavrilovska-Brzanov A1, Petrusheva A1, Lleshi A1

 

1University Clinic for Traumatology, Orthopedic Diseases, Anesthesiology, Reanimation and Intensive Care Medicine and Emergency Department, Clinical Center “Mother Theresa” Faculty of Medicine, “Ss. Cyril and Methodius” University, Skopje, Republic of North Macedonia

2City General Hospital “GOB 8th of September”- Skopje, Republic of North Macedonia

 

Abstract

Cerebral palsy (CP) is a group of non-progressive neurological disorders affecting posture and movement, mostly resulting from perinatal intrauterine disorders to the developing infant brain.

A 6-years old, male patient with spastic cerebral palsy (CP), which predominantly affected the right extremities more than the left ones, required dental surgical treatment of multiple tooth extractions and restorations, under general anesthesia. He received allogenic umbilical cord derived mesenchymal stem cells treatment one time, 6 months before the dental intervention.

The intervention under general anesthesia lasted approximately one hour and concluded successfully. Muscle relaxants were purposely avoided. The anesthesia was reversed and the patient was extubated successfully without complications and there was no sign of any adverse reactions postoperatively.

Key words: Cerebral palsy, dental surgery, disabilities, general anesthesia, mesenchymal stem cells, pediatric patient

 

References:

  1. Shaikh SI, Hegade G. Role of anesthesiologist in the management of a child with cerebral palsy. Anesth Essays Res. 2017 Jul-Sep;11(3):544–9.https://doi.org/10.4103/0259-1162.194569.
  2. Maranhão MV. Anesthesia and cerebral palsy. Rev Bras Anestesiol. 2005;55:680–702 https://doi.org/10.1590/s0034-70942005000600012
  1. Murphy N, Such-Neibar T. Cerebral palsy diagnosis and management: The state of the art. Curr Probl Pediatr Adolesc Health Care. 2003;33:146–69. https://doi.org/10.1016/s1538-5442(03)00002-6
  2. Theroux MC, Akins RE. Surgery and anesthesia for children who have cerebral palsy. Anesthesiol Clin North America. 2005;23:733–43. https://doi.org/10.1016/j.atc.2005.08.001
  3. Jacobsson B, Hagberg G. Antenatal risk factors for cerebral palsy. Best Pract Res Clin Obstet Gynaecol. 2004;18:425–36. https://doi.org/10.1016/j.bpobgyn.2004.02.011
  4. Wimalasundera N, Stevenson VL. Cerebral palsy. Pract Neurol. 2016 Jun;16(3):184-94. Epub 2016 Feb 2. https://doi.org/10.1136/practneurol-2015-001184
  5. Dylan Parry P, Neeraj S. Cerebral palsy and anesthesia, Continuing Education in Anaesthesia Critical Care & Pain 2010, 10(3):72–76. https://doi.org/10.1093/bjaceaccp/mkq013
  6. Poranee W, John S. Cerebral palsy and anaesthesia. Pediatric Anaesthesia, 2002;12(4):296-303.https://doi.org/10.1046/j.1460-9592.2002.00635.x
  7. Miller B, Rondeau B. Anesthetic considerations in patients with cerebral palsy. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2024, 01. [Updated 2023 Aug 5].Available from: https://www.ncbi.nlm.nih.gov/books/NBK572057/
  1. Pradopo S, Khairani F, Sudarsono W, Masyithan M, Udijanto T. General anesthesia in the dental management of a child with cerebral palsy and autism: A Case Report. ndonesian Journal of Dental Medicine 2019;07:1.http://dx.doi.org/10.20473/ijdm.v1i1.2018.1-4
  2. Wass CT, Warner ME, Worrell GA, et al. Effect of general anesthesia in patients with cerebral palsy at the turn of the new millennium: a population-based study evaluating perioperative outcome and brief overview of anesthetic implications of this coexisting disease. J Child Neurol. 2012 Jul;27(7):859–66. https://doi.org/10.1177/0883073811428378
  3. Paprocka J, Kaminiów K, Kozak S, Sztuba K, Emich-Widera E. Stem cell therapies for cerebral palsy and autism spectrum disorder—a systematic review. Brain Sci. 2021 Dec;11(12):1606. https://doi.org/10.3390/brainsci11121606
  4. Escanilla-Casal A, Aznar-Gómez M, Viaño JM, López-Giménez A, Rivera-Baró A. Dental treatment under general anesthesia in a group of patients with cerebral palsy and a group of healthy pediatric patients. Med Oral Patol Oral Cir Bucal. 2014 Sep 1;19(5):e490-4. https://doi.org/10.4317/medoral.19568