Abstract
Study objective To identify guidelines for anesthesia management and determine whether general anesthesia is safe for pediatric patients on ketogenic diet (KD). Design Retrospective medical record review. Setting Postoperative recovery area. Patients All pediatric patients who underwent general anesthesia while on KD between 2009 and 2014 were reviewed. We identified 24 patients who underwent a total of 33 procedures. All children were on KD due to intractable epilepsy. The age of patients ranged from 1 to 15 years. Intervention General anesthesia for the scheduled procedures. Measurements Patients’ demographics, seizure history, type of procedure; perioperative blood chemistry, medications including the anesthesia administered, and postoperative complications. Main results Twenty-four patients underwent a total of 33 procedures. The duration of KD treatment at the time of general anesthesia ranged from 4 days to 8 years. Among the 33 procedures, 3 patients had complications that could be attributable to KD and general anesthesia. A 9-year-old patient experienced increased seizures on postoperative day 0. An 8-year-old patient with hydropcephalus developed metabolic acidosis on postoperative day 1, and a 7-year-old patient's procedure was complicated by respiratory distress and increased seizure activity in the postanesthesia care unit. Conclusion This study showed that it is relatively safe for children on KD to undergo general anesthesia. The 3 complications attributable to general anesthesia were mild, and the increased seizure frequencies in 2 patients returned back to baseline in 24 hours. Although normal saline is considered more beneficial than lactated Ringer's solution in patients on KD, normal saline should also be administered carefully because of the risk of exacerbating patients’ metabolic acidosis. One should be aware of the potential change of the ketogenic status due to drugs given intraoperatively.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 170-175 |
| Number of pages | 6 |
| Journal | Journal of Clinical Anesthesia |
| Volume | 35 |
| DOIs | |
| State | Published - Dec 1 2016 |
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Keywords
- Anesthesia
- General
- Ketogenic diet
- Ketosis
- Postoperative complications
ASJC Scopus subject areas
- Medicine(all)
- Anesthesiology and Pain Medicine
Cite this
Pediatric patients on ketogenic diet undergoing general anesthesia—a medical record review. / Soysal, Elif; Gries, Heike; Wray, Carter.
In: Journal of Clinical Anesthesia, Vol. 35, 01.12.2016, p. 170-175.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Pediatric patients on ketogenic diet undergoing general anesthesia—a medical record review
AU - Soysal, Elif
AU - Gries, Heike
AU - Wray, Carter
PY - 2016/12/1
Y1 - 2016/12/1
N2 - Study objective To identify guidelines for anesthesia management and determine whether general anesthesia is safe for pediatric patients on ketogenic diet (KD). Design Retrospective medical record review. Setting Postoperative recovery area. Patients All pediatric patients who underwent general anesthesia while on KD between 2009 and 2014 were reviewed. We identified 24 patients who underwent a total of 33 procedures. All children were on KD due to intractable epilepsy. The age of patients ranged from 1 to 15 years. Intervention General anesthesia for the scheduled procedures. Measurements Patients’ demographics, seizure history, type of procedure; perioperative blood chemistry, medications including the anesthesia administered, and postoperative complications. Main results Twenty-four patients underwent a total of 33 procedures. The duration of KD treatment at the time of general anesthesia ranged from 4 days to 8 years. Among the 33 procedures, 3 patients had complications that could be attributable to KD and general anesthesia. A 9-year-old patient experienced increased seizures on postoperative day 0. An 8-year-old patient with hydropcephalus developed metabolic acidosis on postoperative day 1, and a 7-year-old patient's procedure was complicated by respiratory distress and increased seizure activity in the postanesthesia care unit. Conclusion This study showed that it is relatively safe for children on KD to undergo general anesthesia. The 3 complications attributable to general anesthesia were mild, and the increased seizure frequencies in 2 patients returned back to baseline in 24 hours. Although normal saline is considered more beneficial than lactated Ringer's solution in patients on KD, normal saline should also be administered carefully because of the risk of exacerbating patients’ metabolic acidosis. One should be aware of the potential change of the ketogenic status due to drugs given intraoperatively.
AB - Study objective To identify guidelines for anesthesia management and determine whether general anesthesia is safe for pediatric patients on ketogenic diet (KD). Design Retrospective medical record review. Setting Postoperative recovery area. Patients All pediatric patients who underwent general anesthesia while on KD between 2009 and 2014 were reviewed. We identified 24 patients who underwent a total of 33 procedures. All children were on KD due to intractable epilepsy. The age of patients ranged from 1 to 15 years. Intervention General anesthesia for the scheduled procedures. Measurements Patients’ demographics, seizure history, type of procedure; perioperative blood chemistry, medications including the anesthesia administered, and postoperative complications. Main results Twenty-four patients underwent a total of 33 procedures. The duration of KD treatment at the time of general anesthesia ranged from 4 days to 8 years. Among the 33 procedures, 3 patients had complications that could be attributable to KD and general anesthesia. A 9-year-old patient experienced increased seizures on postoperative day 0. An 8-year-old patient with hydropcephalus developed metabolic acidosis on postoperative day 1, and a 7-year-old patient's procedure was complicated by respiratory distress and increased seizure activity in the postanesthesia care unit. Conclusion This study showed that it is relatively safe for children on KD to undergo general anesthesia. The 3 complications attributable to general anesthesia were mild, and the increased seizure frequencies in 2 patients returned back to baseline in 24 hours. Although normal saline is considered more beneficial than lactated Ringer's solution in patients on KD, normal saline should also be administered carefully because of the risk of exacerbating patients’ metabolic acidosis. One should be aware of the potential change of the ketogenic status due to drugs given intraoperatively.
KW - Anesthesia
KW - General
KW - Ketogenic diet
KW - Ketosis
KW - Postoperative complications
UR - http://www.scopus.com/inward/record.url?scp=84982284195&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84982284195&partnerID=8YFLogxK
U2 - 10.1016/j.jclinane.2016.04.010
DO - 10.1016/j.jclinane.2016.04.010
M3 - Article
C2 - 27871516
AN - SCOPUS:84982284195
VL - 35
SP - 170
EP - 175
JO - Journal of Clinical Anesthesia
JF - Journal of Clinical Anesthesia
SN - 0952-8180
ER -