Monitoring of Blood Pressure is not Enough to Avoid Neonatal Postoperative Encephalopathy
Abstract Background Neonatal encephalopathy with seizures after general anesthesia not occurring in infants undergoing cardiac or major neurosurgery is very uncommon. An ischemic origin due to cerebral hypoperfusion from perioperative hypotension has been suggested, but there is a lack...
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2018-07-01
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doaj-af194541ec2747e0b1100293284198112020-11-25T02:38:09ZengThieme Medical Publishers, Inc.American Journal of Perinatology Reports2157-69982157-70052018-07-010803e192e19410.1055/s-0038-1668565Monitoring of Blood Pressure is not Enough to Avoid Neonatal Postoperative EncephalopathySimón Pedro Lubián López0Amaya Zuazo Ojeda1Gema Jimenez Gómez2Isabel Benavente Fernández3Neonatology Department, “Puerta del Mar” University Hospital, Cadiz, Spain. Fundación Nene (Neonatal Neurology Research GroupRadiology Department, “Puerta del Mar” University Hospital, Cadiz, SpainResearch Unit, “Puerta del Mar” University Hospital, Cadiz, SpainNeonatology Department, “Puerta del Mar” University Hospital, Cadiz, Spain. Fundación Nene (Neonatal Neurology Research GroupAbstract Background Neonatal encephalopathy with seizures after general anesthesia not occurring in infants undergoing cardiac or major neurosurgery is very uncommon. An ischemic origin due to cerebral hypoperfusion from perioperative hypotension has been suggested, but there is a lack of a consensus definition for intraoperatory hypotension in neonates. Case Report We report the first case of neonatal encephalopathy with seizures in a neonate with anorectal malformation. He underwent a colostomy with caudal anesthesia combined with light general anesthesia. Intraoperative systolic blood pressure and mean blood pressure values were considered normal. Thirty-two hours after the intervention, the patient presented electroclinical seizures. Diffusion-weighted imaging showed bilateral involvement with reduced diffusivity in the watershed areas of the middle cerebral artery and posterior cerebral artery. Conclusion Perioperative monitoring of blood pressure is not enough in neonatal surgery. Cerebral magnetic resonance imaging should be considered in infants with noncardiac congenital anomalies after neonatal surgery and long-term follow-up is required.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0038-1668565encephalopathypostoperativehypotensioncaudal anesthesiadiffusion-weighted imagingneonate |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Simón Pedro Lubián López Amaya Zuazo Ojeda Gema Jimenez Gómez Isabel Benavente Fernández |
spellingShingle |
Simón Pedro Lubián López Amaya Zuazo Ojeda Gema Jimenez Gómez Isabel Benavente Fernández Monitoring of Blood Pressure is not Enough to Avoid Neonatal Postoperative Encephalopathy American Journal of Perinatology Reports encephalopathy postoperative hypotension caudal anesthesia diffusion-weighted imaging neonate |
author_facet |
Simón Pedro Lubián López Amaya Zuazo Ojeda Gema Jimenez Gómez Isabel Benavente Fernández |
author_sort |
Simón Pedro Lubián López |
title |
Monitoring of Blood Pressure is not Enough to Avoid Neonatal Postoperative Encephalopathy |
title_short |
Monitoring of Blood Pressure is not Enough to Avoid Neonatal Postoperative Encephalopathy |
title_full |
Monitoring of Blood Pressure is not Enough to Avoid Neonatal Postoperative Encephalopathy |
title_fullStr |
Monitoring of Blood Pressure is not Enough to Avoid Neonatal Postoperative Encephalopathy |
title_full_unstemmed |
Monitoring of Blood Pressure is not Enough to Avoid Neonatal Postoperative Encephalopathy |
title_sort |
monitoring of blood pressure is not enough to avoid neonatal postoperative encephalopathy |
publisher |
Thieme Medical Publishers, Inc. |
series |
American Journal of Perinatology Reports |
issn |
2157-6998 2157-7005 |
publishDate |
2018-07-01 |
description |
Abstract
Background Neonatal encephalopathy with seizures after general anesthesia not occurring in infants undergoing cardiac or major neurosurgery is very uncommon. An ischemic origin due to cerebral hypoperfusion from perioperative hypotension has been suggested, but there is a lack of a consensus definition for intraoperatory hypotension in neonates.
Case Report We report the first case of neonatal encephalopathy with seizures in a neonate with anorectal malformation. He underwent a colostomy with caudal anesthesia combined with light general anesthesia. Intraoperative systolic blood pressure and mean blood pressure values were considered normal. Thirty-two hours after the intervention, the patient presented electroclinical seizures. Diffusion-weighted imaging showed bilateral involvement with reduced diffusivity in the watershed areas of the middle cerebral artery and posterior cerebral artery.
Conclusion Perioperative monitoring of blood pressure is not enough in neonatal surgery. Cerebral magnetic resonance imaging should be considered in infants with noncardiac congenital anomalies after neonatal surgery and long-term follow-up is required. |
topic |
encephalopathy postoperative hypotension caudal anesthesia diffusion-weighted imaging neonate |
url |
http://www.thieme-connect.de/DOI/DOI?10.1055/s-0038-1668565 |
work_keys_str_mv |
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