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[Sevoflurane sedation protocol in children with cerebral palsy undergoing botulinum toxin-A injections]

A León-Valenzuela1, C Román Malo2, M González López3

  • 1Unidad Gestión Clínica Medicina Física y Rehabilitación, Hospital Universitario Puerto Real, Puerto Real, Cádiz, España; Departamento Materno Infantil, Facultad de Medicina, Universidad de Cádiz, Cádiz, España; Grupo iRehab, Instituto de Investigación e Innovación Biomédica de Cádiz, Cádiz, España.

Rehabilitacion
|January 20, 2021
PubMed

Insights

Sevoflurane sedation effectively manages pain and agitation during botulinum toxin-A (BoNT-A) infiltrations in children with cerebral palsy (CP). This safe and well-tolerated protocol enhances collaboration and professional satisfaction.

Area of Science:

  • Pediatric Anesthesiology
  • Neuromuscular Disorders
  • Pain Management

Background:

  • Botulinum toxin-A (BoNT-A) injections are crucial for managing spasticity in children with cerebral palsy (CP).
  • Sedation is often required to manage pain and agitation during these procedures.
  • Evaluating safe and effective sedation protocols is essential for improving patient care.

Purpose of the Study:

  • To assess the safety and efficacy of sevoflurane sedation for BoNT-A infiltration in pediatric CP patients.
  • To describe the protocol's impact on pain and agitation control.
  • To evaluate professional satisfaction and adverse events.

Main Methods:

  • Retrospective observational study of 74 children with CP undergoing BoNT-A infiltration with sevoflurane sedation (Nov 2012 - Dec 2019).
  • Review of demographic, clinical, and functional data.
  • Analysis of sedation effectiveness, adverse events (AE), and professional satisfaction.

Main Results:

  • 387 sedations were performed with 100% effectiveness.
  • Adverse events occurred in 6.02% of procedures (nausea, vomiting, transient hypoxemia); no severe AE were reported.
  • Effective sedation facilitated collaboration, improved professional satisfaction, and allowed for complex infiltrations.

Conclusions:

  • Sevoflurane sedation is a safe and effective option for managing pain and agitation during BoNT-A infiltrations in children with CP.
  • The protocol demonstrates good tolerance and facilitates procedures, including examination under sedation and multilevel infiltrations.
  • This approach shows promising results for daily clinical practice in pediatric CP management.
Abstract

Keywords:
AnalgesiaBotulinum toxin-ACerebral PalsyDolorEspasticidadPainParálisis cerebralSedaciónSedationSpasticityToxina botulínica A

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