Parent Fact Sheet: Preparing for Orthopaedic Surgery in a Child with Cerebral Palsy (CP)

"I know that they're going to get better after" in white and yellow text over a pink background

Why pre-op planning matters

Children with CP may have additional medical needs (breathing, feeding, seizures, muscle tone, skin). A thorough pre-op evaluation helps reduce complications and supports safe recovery.

What the team will review
• Medical history: past surgeries/anesthesia issues, allergies (including latex/adhesives), current
medications/supplements.
• Functional goals: comfort, sitting/positioning, transfers, walking (if applicable), hygiene/caregiver needs.
• Imaging: often hip X-rays (hip surveillance) and other imaging if needed for planning.

Key health areas that affect safety
• Breathing/lungs: aspiration, pneumonia history, mucus clearance, chronic cough, snoring/sleep apnea,
CPAP/ventilator or trach needs.
• Seizures/neurology: seizure medication plan during fasting/anesthesia; rescue plan; special planning for VP
shunt or baclofen pump if present.
• Feeding/GI/nutrition: reflux, tube feeding (G-tube/GJ/J-tube), growth/nutrition, constipation plan before and
after surgery.
• Skin & wound healing: skin check before surgery; pressure sore prevention; sensitivity to tapes/dressings;
infection prevention.
• Blood loss: blood count checks; strategies to reduce bleeding; transfusion planning when needed.
What parents can do before surgery
• Bring an updated medication list (including vitamins/OTC).
• Tell the team about snoring/sleep apnea, reflux/aspiration, pneumonia history, constipation, and prior
anesthesia problems.
• Discuss equipment needs early (wheelchair, hospital bed, commode/toilet chair, braces/orthotics).
• Confirm bowel regimen plan (constipation prevention is very important after surgery).

Pain control & communication
Pain may look different in children with CP. Share how your child shows pain (crying, stiffening, irritability,
withdrawal). Many teams use a multimodal pain plan (regional blocks + non-opioid medicines + opioids only when
needed).

After surgery: when to call
• Trouble breathing, uncontrolled pain, persistent vomiting, inability to tolerate feeds.
• No stool for several days or severe constipation.
• Fever, increasing redness/drainage, incision opening, new skin breakdown/pressure sore.
• New leg swelling or sudden change in comfort/movement.

Reference:

Chambers HG, et al. Preoperative Evaluation of the Child With Cerebral Palsy. Journal of the Pediatric Orthopaedic Society of North
America (2026).