Pediatric anesthesia & critical care
A retrospective observational cohort study of the anesthetic management and outcomes of pediatric patients with Alexander disease undergoing lumbar puncture or magnetic resonance imaging
Authors' conclusion
In this single-center study, patients with Alexander disease did not experience frequent or irreversible complications while undergoing general anesthesia/MAC. Co-morbid symptoms were not increased postanesthesia.
Study context
- Population
- Pediatric patients with Alexander disease undergoing MRI and/or lumbar puncture at a quaternary-care children's hospitalprocedures in 40 patients
- Participants
- 64 patients
- Exposure
- GA/monitored anesthesia care (MAC) vs no anesthesia for MRI and/or lumbar puncture
- GA/MACn = 56
- Nonanesthetizedn = 8reference
- Outcome
- Anesthesia-related complications under anesthesia and in the subsequent 24 h
- Follow-up
- 24 h
Methodological detailssingle-center, descriptive
- Single-center
- Descriptive
Main finding
As reported in the abstract
Procedures requiring GA or MAC
- Median age, GA/MAC vs nonanesthetized (IQR)
- 6 years [IQR 3.8; 9] vs. 14.5 years [IQR 12.8; 17.5]
- Inhalational induction
- 48 (85.7%)
- RSI
- 2 (3.6%)
- Ambulatory procedures
- 53 (94.6%)
Observational data: associations, not effects.
Further findings
Age
Preprocedure symptoms
- Dysphagia, GA/MAC vs nonanesthetized
- 78.6% vs. 87.5%
- Seizures, GA/MAC vs nonanesthetized
- 62.5% vs. 25%
- Recurrent vomiting, GA/MAC vs nonanesthetized
- 17.9% vs. 25%
Anesthetic technique (GA/MAC)
- Inhalational induction
- 48 (85.7%)
- RSI
- 2 (3.6%)
- Ambulatory procedures
- 53 (94.6%)
Safety
Anesthesia-related complications (under anesthesia and in the subsequent 24 h)
- Hypotension resolving with ephedrine
- 8 (14.3%)
- Postprocedure emergence agitation
- 1 (1.8%)
- Postprocedure vomiting
- 1 (1.8%)
- Serious complications rare; no aspiration or seizures
- No inpatients required escalation in acuity of care
Original publication
A retrospective observational cohort study of the anesthetic management and outcomes of pediatric patients with Alexander disease undergoing lumbar puncture or magnetic resonance imaging. Paediatr Anaesth. Published 31 May 2024. doi:10.
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