Anaesthesia in craniosynostosis
González Cárdenas, Víctor Hugo | 2014-07-14
Craniosynostosis is a congenital disorder requiring extensive reconstructive surgery thatentails a high probability of severe bleeding, massive transfusion and difficult airway man-agement. Considering that the anaesthetic management for this procedure has specialrequirements and priority targets, presenting the experience of the anaesthesiology depart-ment working under the programme for surgery of craniofacial abnormalities is of thegreatest importance.
Objective: Describe the behaviour of anaesthetic variables during the perioperative period inpatients taken to craniosynostosis correction at Hospital Infantil Universitario de San José.Methods: Retrospective observational cohort study in patients taken to surgery between Jan-uary 1st 2008 and January 31st 2012. Data were collected from electronic clinical records andanaesthesia records.
Results: The most relevant data were haemorrhage and transfusion. Blood loss was 35.6 cc/kg(SD = 17.4), considered as severe haemorrhage. Patients receiving tranexamic acid did notshow lower intra-operative levels of blood loss or packed red blood cell (PRBC) transfusions,shorter mechanical ventilation or ICU (intensive care unit) length of stay. We observed asmaller number of PRBC transfusions in patients in the ICU who received desmopressin.
Conclusions: We suggest that neither tranexamic acid (14 mg/kg) nor desmopressin (0.36 mg/kg) in this cohort correlated with reduced haemorrhage or smaller volumes of intra-operative PRBCs. We only describe a smaller volume of transfused PRBCs in the ICU associated with the use of desmopressin.