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Anaesthetic Challenges in a Paediatric Case of Cerebral Palsy

Pallavi Suman, Nirmal Kumar, Sandip Kumar Rahul

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Pediatric Education and Research 13(2):p 47-49, July -Dec 2025. | DOI: 10.21088/per.2321.1644.13325.1

How Cite This Article:

Pallavi Suman, Nirmal Kumar, Sandip Kumar Rahul. Anaesthetic Challenges in a Paediatric Case of Cerebral Palsy. Pediatr. Edu. Res. 2025; 13(2): 47-49.

Timeline

Received : November 24, 2025         Accepted : December 22, 2025          Published : December 30, 2025

Abstract

Cerebral Palsy (CP), a non-progressive central motor disorder is characterized by deformities which are progressive and often merit corrective surgeries to limit these deformities for proper rehabilitation of the patient. Anaesthesia in such patients is challenging due to disabilities and altered pharmacokinetics of different drugs. Specific concerns include intraoperative hypothermia, slow emergence, increased risks of aspiration due to excessive Oro-pharyngeal secretions and gastro-esophageal reflux, recurrent Pneumonia, history of seizures and anti-seizure medications, respiratory depression, and post-operative pain and muscle spasms. We describe the anesthetic management of a five-year-male with spastic CP, who underwent corrective surgery for bilateral Congenital Telipes Equino varus (CTEV) and deformities in lower limb and emphasize upon these risks and their management. This case presented to the pediatric outpatients’ clinic as a diagnosed case of spastic cerebral palsy with seizures and bilateral congenital telipes equino varus (CTEV) and lower limb deformity. He also had a past history of recurrent pneumonia for which he received treatment in the pediatric medicine department. Child had been on Valproate for seizures, Baclofen for muscle spasms and Ranitidine for gastro-esophageal reflux disease (GERD). Surgery had been cancelled several times in the past due to the poor general condition of the child and the high risk involved. On examination, this patient weighed 15 KG and was pale, anicteric and tachycardic with a blood pressure of 96/64 mm Hg. He had delayed developmental milestones including language, social and mental milestones. Airway was normal with Mallampatti grade -1 on examination. Excessive oral and pharyngeal secretions were present and occasional drooling of saliva was noticed. There was also the presence of gastro-esophageal reflux. Patient had obvious Kypho-scoliosis and spinal deformity. He had bilateral CTEV with several contractures. Increased muscle tone, tense contracted muscles and exaggerated deep tendon reflexes were other significant findings. Examination of the respiratory system revealed bilateral equal air entry but there was crepitation in the right middle

References

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Data Sharing Statement

There are no additional data available. All raw data and code are available upon request.

Funding

This research received no funding.

Author Contributions

all authors contributed significantly to the work and approve its publication.

Acknowledgements

We would like to express our gratitude to the patients, their families, and all those who have contributed to this study.

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Cite this article

Pallavi Suman, Nirmal Kumar, Sandip Kumar Rahul. Anaesthetic Challenges in a Paediatric Case of Cerebral Palsy. Pediatr. Edu. Res. 2025; 13(2): 47-49.

Licence:

Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)

This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.


Received Accepted Published
November 24, 2025 December 22, 2025 December 30, 2025
DOI: 10.21088/per.2321.1644.13325.1

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Timeline

Received November 24, 2025
Accepted December 22, 2025
Published December 30, 2025

licence

Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)

This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.



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