Avtor/Urednik		Šervicl-Kuchler, D; Berden, N
Naslov		Pred- in pooperativna obravnava ter anestezija otrok s cerebralno paralizo
Prevedeni naslov		Pre- in postoperative management and anaesthesia in children with cerebral palsy
Tip		članek
Vir		Slov Pediatr
Vol. in št.		Letnik 13, št. 1
Leto izdaje		2006
Obseg		str. 36-43
Jezik		slo
Abstrakt		Cerebral palsy is a non-progressive disorder of motion and posture resulting from damage to the central nervous system. The clinical manifestations and the degree of impairment vary considerably from child to child. Orthopaedic, dental and neurosurgical operations are the most frequently performed procedures in these children. Preparation of children with CP for surgical procedures is demanding because they often have coexisting gastrointestinal and respiratory disorders, epilepsy and visual and hearing problems. This preparation requires cooperation between the paediatrician and anaesthetist. In children with CP vascular access and airway maintenance during induction may be difficult. There is a high incidence of postoperative vomiting and hypothermia. Their responses to anaesthetic agents are different from those experienced by the rest of the population. Allergy to latex is common. The particular demands of postoperative management are already apparent in the recovery ward. Effective pain relief and the prevention of spasms, which make the pain worse, are important. In both the perioperative and postoperative periods it is important to prevent the development of decubitus ulcers. Chest physiotherapy is given to prevent respiratory complications. Preparation of children with CP for surgery and anaesthesia must be undertaken by an experienced team, as only in this way is it possible to avoid numerous complications.
Izvleček		Cerebralna paraliza je nenapredujoča bolezen centralnega živčnega sistema. Klinična slika in stopnja prizadetosti je pri posameznih otrocih zelo različna. Najpogostejši kirurški posegi so ortopedski, zobni in nevrokirurški. Priprava otrok na poseg je zahtevna, saj imajo ti otroci pogosto prizadeta prebavila, dihala, vidne in slušne motnje ter epilepsijo. Pri pripravi na operativni poseg je pomembno sodelovanje pediatra in anesteziologa. Pri otrocih s cerebralno paralizo je pogosto oteženo uvajanje venske poti ter vzpostavitev dihalne poti. Otroci so nagnjeni k bruhanju in k hipotermiji. Na anestezijske učinkovine se odzivajo drugače kot ostala populacija. Pogosta je alergija na lateks. Pooperativna oskrba ima svoje posebnosti, ki se kažejo že v prebujevalnici. Pomembno je zdravljenje bolečine in preprečevanje krčev, ki bolečino še poslabšajo. Tako v peri - kot v pooperativnem obdobju moramo preprečevati nastanek preležanin. Z respiratorno fizioterapijo preprečujemo respiratorne zaplete. Priprava otrok s CP na operativni poseg in anestezija morata biti v rokah izkušene ekipe, saj se le tako lahko izognemo številnim zapletom.
Deskriptorji		CEREBRAL PALSY PREOPERATIVE CARE POSTOPERATIVE CARE CHILD