An Audit of Anaesthesia for Paediatric Neurosurgical Procedures in Ibadan, Nigeria

Abstract

Introduction: We report our experience in the anaesthetic management of children for neurosurgical procedures in our centre.
Methods: This was a prospective clinical audit of all paediatric neurosurgical patients who had general anaesthesia at a tertiary centre between January and December 2011.
Results: 350 patients had neurosurgical procedures in 2011, 95(27.14%) were children. The ages ranged from 2 days to 18 years with mean age of 11 ± 7.2 months. There were 25 neonates and 35 infants. Forty four patients (46.3%) presented with hydrocephalus, 26 (27.4%) with meningocoele, 10 (10.5%) with neurotrauma, 10 (10.5%) with brain tumor, 2(2.1%) with spinal tumor and 3 (3.3%) with subdural empyema. Endoscopic third ventriculostomy was the commonest procedure performed (38.8%) mostly in the infants, repair of the meningocoeles (27.4%) mostly in the neonates while craniotomies for tumor excision (10.5%) and haematoma evacuation (7.4%) were mostly in older children above 5 years. Intraoperative complications were recorded in 35 patients (36.84%), 3 neonates had difficult intubation, 2 infants had oxygen saturation less than 92% and 3 infants had laryngospasm during induction of anaesthesia. Hypothermia was recorded in 4 patients mostly in neonates and infants, while16 patients had arrhythmias and 22 patients had delayed recovery postoperatively.
Conclusion: Anaesthesia for paediatric patients presenting for neurosurgical procedures is challenging and patients are prone to perioperative complications.

Keywords: Paediatric anaesthesia, neurosurgery, perioperative complications