Clinical Results of Sevoflurane Inhalation Anesthesia for Botulinum Neurotoxin Treatment in Children with Cerebral Palsy

Abstract

Objective: The botulinum neurotoxin type A (BoNT-A) intramuscular injection is a safe and reliable method to treat increased spasticity in spastic cerebral palsy (CP). Although BNT-A injections may be administered under local anesthesia, many clinicians prefer injections under general anesthesia in the operating room, especially for children. The purpose of the present study was to evaluate the safety and efficacy of administering BNT-A injections to children with spastic CP under sevoflurane mask anesthesia. Materials and Methods: Files of 61 children with CP who received 191 BoNT-A injections under sevoflurane mask anesthesia were analyzed retrospectively. The time from the beginning of anesthesia to the end of the procedure was recorded. The BNT-A dose per muscle was 3–6 IU/kg body weight for lower extremity muscles and 1–3 IU/kg body weight for upper extremity muscles. Results: The mean age of the children was 42 months. The mean procedure time was 15 min. There were no complications related to anesthesia or the BTN-A injection procedure. Conclusion: BTN-A injections in children with spastic CP may be safely and effectively administered under sevoflurane mask anesthesia without any procedural or anesthetic complications.