Brachial plexus birth injuries: anaesthesia for surgical nerve reconstruction and preoperative myelography and computed tomographic myelography

Abstract

Surgical nerve reconstruction for brachial plexus birth injuries and preoperative myelography and computed tomographic (CT) myelography require special anaesthetic considerations. Anaesthesia and medical records were retrospectively reviewed for the infants who underwent myelography, CT myelography (n=37) and microsurgical nerve reconstruction (n=34) at our institution from January 1993 to August 1996. Anaesthetic considerations include long duration of operation, perioperative respiratory complications and plaster application which makes reintubation difficult. Myelography for diagnosis requires a specific positioning of the patient with the head fixed in a midline and prone position.

Assessment of the usefulness of X-ray myelography and magnetic resonance myelography, performed with an open low-field device, in diagnosing perinatal preganglionic injuries of the brachial lexus

“…Diagnostic imaging in children requires deep sedation or general anaesthesia because of the patients’ uncontrollable movements [1, 4]. Interpretation of the results may be more difficult than in adults because of pulsation of the cerebrospinal fluid and the necessity to assess the small area of interest [1].…”

Perioperative Complications Associated with Brachial Plexus Repair in Infants

“…Previous reports in the anaesthesia literature have described a variety of potential postoperative complications associated with brachial plexus surgery in neonates (Hazama et al, 1999;Seveso et al, 1983). In addition to respiratory abnormalities including atelectasis, PCO 2 elevation, and increased bronchial secretions; problems with body temperature control have also been noted.…”

“…Over the past decade, early operative intervention has become the treatment of choice for infants with brachial plexus birth injuries who fail to demonstrate appropriate spontaneous recovery during the first 3-8 months of life (Gilbert, 2001;Kay, 1998;Sherburn et al, 1997;Sloof, 1995). In spite of the rapidly increasing number of surgical cases performed, little attention has been given to perioperative management, including anaesthetic techniques and associated surgical risks (Birch, 2000;Borrero, 2001;Hazama et al, 1999;La Scala et al, 2001;Seveso et al, 1983). This report analyses the perioperative complications in a series of operative cases.…”

Cervical natal trauma: neurologic symptomatology and manual therapy

“…The carried out researches are the first joint experience of pediatric neurolo gists and manual therapists. (12). Основными жалоба ми у родителей детей 1-й группы были лево сторонняя (у 40%) и правосторонняя (у 40%) кривошея, асимметрия лица (у 73%), тремор рук (у 33%), косолапость (у 20%), ограниче ние поворота головы (у 40%), срыгивания (у 20%), слабость, небольшая амплитуда движе ний в руках (у 40%), опора на цыпочки при попытке поставить ребенка (у 47%), диффуз ная мышечная гипотония(у 20%), отставание в развитии по сравнению с другими детьми данного возраста (у 33%), и общее беспокой ство и беспокойный сон (у 53%).…”