Neurophysiological factors associated with postoperative airway management complications after posterior fossa surgery in children.

OBJECTIVES

The study aims were to explore whether perioperative changes in somatosensory evoked potentials (SEPs) and motor evoked potentials (MEPs) provide a reliable indicator for assessing postoperative airway management complications.

METHODS

The study was a retrospective analysis of patients under 18 years old who underwent posterior cranial fossa surgery between December 2019 and November 2023. Patient demographics, imaging data, surgical records, anesthesia records, neurophysiological data, and airway management complications were reviewed. The airway management complications included extubation failure, tracheostomy, and aspiration. The primary outcome of the study was the efficacy of perioperative changes in SEPs and MEPs for postoperative airway management complications.

RESULTS

A reduction in postoperative SEP amplitude was associated with postoperative airway management complications (P = 0.018). The combination of feasible preoperative SEP recording followed by a reduction in postoperative SEP amplitude emerged as a risk factor for complications related to postoperative airway management (P = 0.007). Patients with airway management complications had more days of intubation, and longer intensive care unit and hospital stays compared to negative patients.

CONCLUSIONS

The combination of feasible preoperative SEP recording followed by a reduction in postoperative SEP amplitude was a significant risk factor for postoperative airway management complications.