Title: Anaesthetic Challenges in Primary Cleft Lip and Palate Surgeries: A Retrospective Study
Authors: Chadha Meenu MD, Shrivastava Gaurita MD, DNB, Goyal Praveen MD, Waskel Shailendra DA, Chauhan Jaideep S MDS, Sharma Sarwpriya MDS
DOI: https://dx.doi.org/10.18535/jmscr/v9i3.36
Abstract
Background: Cleft lip and palate are one of the commonest congenital craniofacial anomalies. The aim of this study was to do a retrospective analysis of patients who underwent primary cleft surgeries.
Method: After approval from the institutional ethical committee retrospective analysis of 975 patients who underwent primary cleft lip, primary cleft palate and primary combined surgeries was done. The anaesthesia technique and complications were noted from the anaesthesia records. The data recorded was demographic profile, haemoglobin level, preexisting comorbidities, type of surgery and perioperative complications.
Result: The overall pre-existing morbidities, perioperative and post-operative complications were reported in 109 (11.2%), 117 (12%) and 52 (5.3%) participants respectively. In the pre-existing morbidities, Upper respiratory tract infection (URTI) was reported as the most common pre -existing morbidity (6.7%), various syndromes in 32 patients (3.3%). Congenital cardiac condition occurred in 1.2% In the perioperative complications, bronchospasm occurred in 4.1% most of these patients had URI and difficult intubation occurred in 3.3%. Post operatively 1.2% had bleeding and all of these patients had to be intubated postoperatively. It was noted that difficult intubation was more in cleft palate surgery 19 patients than cleft lip surgery 13 patients. Failed intubation occurred in equal number of patients in cleft lip and palate. Post-operative bleeding was also more in cleft palate surgery and post-operative bronchospasm occurred only in cleft palate surgeries
Conclusion: We observed URTI as the major preoperative challenge in addition to intra and post-operative complications. A thorough preoperative evaluation is imperative.
Keywords: Anesthesia; Cleft lip and palate; Endotracheal Intubation; Pierre Robin; Respiratory tract infection; Anaemia.
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