Perioperative and Late Adverse Events in Patients with Cerebral Palsy

Introduction. Identification of adverse events in the perioperative and late periods is the main condition for safe surgical care for patients with cerebral palsy. The aim of the study — based on a retrospective analysis of medical records, to identify triggers and evaluate the frequency of adverse events in the perioperative and late periods in children with severe forms of cerebral palsy combined with epilepsy who received surgical orthopedic treatment for spastic dislocations (subluxations) of the hips. Materials and methods. The retrospective study included 50 patients with cerebral palsy and epilepsy who underwent hip surgery. Adverse events in the perioperative and late periods were assessed. Results. After surgery, anemia and hyperfibrinogenemia were diagnosed in both groups. One case of epilepsy relapse and an episode of massive nosebleed were registered. Within a year after the operation, resumption of epileptic seizures was registered in 2 children, the parents (guardians) of 2 patients reported a fatal outcome. Conclusion. Adverse events of the perioperative period in children with cerebral palsy and epilepsy in 10 % of cases are caused by the effect of anticonvulsants on the hemostasis system, relapse of seizures. The remote postoperative period in children with cerebral palsy and epilepsy in 4 % of cases can be aggravated by the resumption of seizures against the background of the withdrawal or reduction of the dose of anticonvulsants. The combination of somatic pathology, cerebral insufficiency and epilepsy against the background of cerebral palsy can initiate severe adverse events in the remote postoperative period, including death.