Friday, 17 May 2013

Pre and Post Surgical Protocol in Cerebral Palsy Children

There is no special investigation required for SEMLS by OSSCS concept. Simple blood test and x-ray required in some cases. Total duration of surgery is depending upon many factor but 3-4 hour in diplegic and 5-6 hours in quadriplegic. OSSCS Surgery in lower limb is being performed in epidural anesthesia and upper limb in brachial block.

We try that child is not completely unconscious but in small child medicines only given to take them in sleep. Till now no adverse effect is seen. After taken out from Operation Theater water should be given after two hours and food can be given in evening. After surgery no special precaution is to be taken. Child can turnover and sit on bed also. In this surgery all stiffness and Spasticity can be control by only one procedure and muscle balancing power becomes good.

Normally, physiotherapy started after two weeks of surgery. In starting, exercises done only to decrease pain, increase the range of joints and decrease the stiffness of muscles. Then after 1 month of surgery, strength training exercises and exercises for activities of daily living will start. These strengthening and daily living exercises run for almost six months to one year. After this protocol, exercises will be continued till the adolescent phase and child became independent as much as possible. Child should be under close observation. By close observation, child can be secured by the adverse effect of any further problem.

Child feels easy in walking and balancing. Result of surgery depends on many things like therapy, child’s ability to understand and the main parent’s hard work.  In last five years it is never seen that there is no effect of surgery, ever child who has undergone surgery has shown response depending upon their pre operative functional disability.

Operation in these child done after complete investigation and child is operated only who has need and capability too. In this only physical specially deformities and Plasticity is to be corrected and function recovery depends upon therapy and the child’s ability.

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