Anaesthesia for Cleft Lip and Palate Surgery: Study from a Hospital of Eastern Nepal

Abstract

Introduction
Cleft lip and palate deformity is the most common congenital birth defect caused by complex genetic and environmental factors. Pre-operative management of these patients is always challenging and anesthesia has a great role for the surgery.

Objective
The aim of this study is to evaluate the outcomes including pre-operative election of cases, intra-operative and  post-operative complications in pediatric patients.

Methodology
This is retrospective study conducted on cleft lip and palate repair patients between the ages of 3 months to 12 years, operated under general anesthesia during last six years at Morang Co-operative Hospital, Biratnagar, Nepal. Total 570 patients were assessed with preoperative, intra-operative and post-operative parameters, complications and managements. The MS Excel office and SPSS software was used to analyze the data.

Results
Among 570 patients about one third came from the high mountain and hilly region and the rest from the Tarai. The maximum travel _me to reach the hospital was 2 days. The percentage of cancellation was 22.13% and was mainly due to the respiratory problems. Among 570 patients 352(61.75%) were males. While classifying the cases, 202 cases were presented with only cleft lip, 325 cleft lip and palate combined and 43 patients with isolated cleft palate. Narcotics were not used for analgesia and analgesia maintained with other measures. There was no intra and post-operative death and none of the patient received intra-operative blood transfusion.

Conclusion
Cleft lip and palate surgery in pediatric patients is possible in any hospitals when trained man power and proper operating and post-operative setup is available. Anesthesia for cleft lip and palate is challenging associated with several complications requiring continuous and vigilant anesthetic supervision and management for the better outcome.

Birat Journal of Health Sciences Vol.2/No.1/Issue 2/ Jan - April 2017, Page: 127-133