Anaesthesia For Cleft Lip And Palate Surgery: Universityof Ilorin Teaching Hospital Experience

Abstract

Background: Providing anaesthesia for cleft lip and palate surgery presents a considerable challenge to anaesthetists. However, as long as surgery remains the only definitive treatment known to man anaeathetists must be prepared to face the challenge. This is a retrospective study at the university of Ilorin Teaching Hospital, Ilorin.
Objective: To present our anaesthetic experience for the repair of cleft lip and palate over a period of 11 years, with a view to highlighting the problems and challenges.
Methodology: The record of all patients who underwent surgical operation for the repair of cleft lip and palate between January 1996 and December 2006 were retrospectively reviewed. Information was obtained from patients case notes, theatre and anaesthetic registers and anaesthetic charts. Information extracted included patient's demographic characteristics, types of cleft anomaly, preoperative status, anaesthestic management, grade of anaesthesist, specialty of the surgeon, perioperative course and final outcome.
Results: A total of 58 patients were anaesthetised for surgical repair of cleft lip or palate within the study period. However, only 44 case notes could be retrieved for analysis giving a case note retrieval rate of 76%. A total of 51 operations were done on these patients because seven of the patients had repeat repair after the breakdown of the initial repair. There were 20 males and 24 females, giving a male: female ratio of 1:1.2. The ages ranged between 14days and 22years, but majority of the patients (76.5%) were in their first six months of life. All the patients were in the American Society of Anaesthesiologist (ASA)type I. Only one patient had associated congenital anormally of anaesthetic importance. All the patients had general anaesthesia with endotracheal intubation and relaxant technique. Anaesthesia was uneventful in all of them. There was no mortality in our series.
Conclusion: Anaesthetic management for cleft lip and palate surgery can be very safe and highly rewarding even in developing countries with limited resources.
Key Words: Cleft lip and pallate, surgery,
anaesthesia.