Anesthesia in the Child with Cerebral Palsy

Cerebral palsy (CP) is a nonspecific, descriptive term that encompasses a constellation of symptoms due to neurologic lesion resulting from the insult to the developing brain sustained early in life. Although the neurologic lesion in CP is nonprogressive, the motor dysfunction due to spasticity may be progressive leading to spinal deformities, joint contractures, and dislocations requiring medical and surgical interventions. Anesthetic care for children with cerebral palsy is fraught with significant concerns for anesthesia provider and careful attention to all aspects of perioperative care is necessary. Perioperative planning and care should include thorough preoperative assessment, attention to co-morbidities, management of chronic medications, meticulous intraoperative care tomaintaining normothermia, and adequate replacement of fluid and blood products. Postoperative assessment of pain and its management are essential to facilitate recovery and uneventful perioperative course.