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Are children with Angelman syndrome at high risk for anesthetic complications? Journal Article


Authors: Landsman, Ira S; Mitzel, Heather M; Peters, Sarika U; Bichell, Terry J
Article Title: Are children with Angelman syndrome at high risk for anesthetic complications?
Alternate Title: Paediatric anaesthesia
Keywords: Humans; Female; Male; Retrospective Studies; Child; Infant; Child, Preschool; Anesthesia; Anesthetics; Phenotype; Risk; Length of Stay; Intensive Care; Intraoperative Complications; Receptors, GABA-A; GABA Agonists; Midazolam; Propofol; Anesthetics, Intravenous; Angelman Syndrome; Adjuvants, Anesthesia
Journal Title: Paediatric anaesthesia
Volume: 22
Issue: 3
ISSN: 1460-9592
Publisher: Arnette-Blackwell  
Date Published: 2012
Start Page: 263
End Page: 267
DOI/URL:
Notes: OBJECTIVES/AIMS To review seven children with Angelman syndrome (AS) undergoing 16 general anesthetics for both invasive and noninvasive procedures to determine if these children are at greater risk for anesthetic-related complications than the general population. BACKGROUND Children with AS may exhibit unpredictable responses to GABA agonists because of abnormal GABA receptors. These abnormal receptors may affect AS patients' responses to sedation and general anesthesia. METHODS The study design was a retrospective chart review of seven patients with AS who underwent a total of 16 general anesthetics for a variety of invasive and noninvasive procedures between the years 4/25/2005 and 12/31/2010. We reviewed the preoperative orders, anesthesia record and PACU records for preoperative medication orders and intraoperative and PACU adverse events. RESULTS We could not find documentation of complications attributed to the delivery of general anesthesia regardless of chromosomal defect, the use of GABA activating drugs, or a history of seizures. Six patients received a propofol-based anesthetic while 10 patients received potent inhalation agent for anesthetic maintenance. There were no statistical differences between the PACU lengths of stay (LOS) for AS patients as compared to the average PACU LOS for the 60 969 postprocedure patients cared for between 1/1/06 through 12/31/10. CONCLUSIONS We found no data to suggest that these patients demonstrate exaggerated responses to GABA stimulating drugs. In fact, it appears that regardless of the anesthetic agent, the perioperative course was unremarkable.
KUMC Authors
  1. Heather Mitzel
    1 Mitzel