Anesthesia for Stereotactic Radiosurgery in Children

A review of perioperative complications during frameless stereotactic surgery: our institutional experience

“…The procedure may appear to be simple, but complications such as seizures, intraoperative brain bulge, and postoperative neurodefi cits can occur. Our literature search revealed anesthetic management and intraoperative complications associated with framed stereotaxy [11,12]. However, the same has never been reported for frameless stereotaxy.…”

“…Also, their patients were operated under monitored anesthesia care; our patients received general endotracheal anesthesia. In a study by Stokes et al [12], anesthesia-related events were reported in children undergoing stereotactic surgery.…”

Feasibility of Radiosurgery for Malignant Brain Tumors in Infants by Use of Image-guided Robotic Radiosurgery: Preliminary Report

“…Even for older children with thicker skulls, the use of rigid stereotactic frames presents significant problems. The common problems associated with anesthesia (vomiting, tube obstruction and postextubation croup) are magnified by the limited airway access imposed by the rigid frame (3,35). Stokes et al (35), for example, reported four serious anesthetic events in 68 frame-based radiosurgical procedures in children.…”

“…The common problems associated with anesthesia (vomiting, tube obstruction and postextubation croup) are magnified by the limited airway access imposed by the rigid frame (3,35). Stokes et al (35), for example, reported four serious anesthetic events in 68 frame-based radiosurgical procedures in children. Furthermore, fractionated regimens extending for several days or weeks are generally considered impractical if a frame is required.…”

Nerve Blocks in Stereotactic Neurosurgery

“…Stokes et al [4] demonstrated in 1995 that regional anesthesia can be used for stereotactic procedures in pediatric patients and that, if necessary, the patient could receive further sedation as required. The observation of fewer complications in regional anesthesia -with less likelihood of respiratory complications in comparison to general anesthesia -would suggest that analgesia using regional blocks is an alternative with less side effects and a lower risk of complications.…”