Pain management in children with cerebral palsy undergoing reconstructive or palliative hip joint surgery

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Objective. To assess the efficacy and safety of prolonged epidural blockade as a component of anesthesia and postoperative pain analgesia in children with moderate or severe cerebral palsy, concomitant epilepsy and hydrocephalus undergoing reconstructive or palliative hip joint surgery. Material and methods. A retrospective analysis included 134 patients with spastic hip dislocation for the period from 2015 to 2018. All patients underwent single-stage multi-level orthopedic procedures on the lower limbs. All patients were divided into 2 groups (n=67): those with concomitant epilepsy and hydrocephalus (group EH) and the control group (CG) without these diseases. Hemodynamic parameters, perioperative need for analgesics, external blood loss and need for blood transfusion, structure of complications were assessed. Results. Insignificant hemodynamic differences were identified at 3 stages of the study. However, these parameters did not have clinical significance, since they were within acceptable physiological values. Other criteria were similar in all groups. Conclusion. Prolonged epidural analgesia is effective and safe component of anesthesia and postoperative analgesia in children with moderate or severe forms of cerebral palsy, concomitant epilepsy and hydrocephalus undergoing reconstructive and palliative hip joint surgery.

Keywords:

cerebral palsy

childhood

epilepsy

hydrocephalus

hip surgery

prolonged epidural analgesia

Authors:

V.V. Evreinov

Ilizarov Russian Research Center 'Reconstructive Traumataligy and Orthopedics' of the Ministry of Health of Russia, Kurgan, Russia

T.A. Zhirova

Center of Specialialized Medical Care 'Chaklin Ural Institute of Traumatology and Orthopedics', Ekaterinburg, Russia

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