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Anaesthesia in cleft lip and cleft palate surgery of children
1Department of Anaesthesiology, Faculty of Medicine, University of Peradeniya.
Insights
This study found that endotracheal halothane anesthesia is a safe and effective method for cleft lip and palate repair in young children, even in resource-limited settings. Zero mortality was observed, highlighting its suitability for developing countries.
Area of Science:
- Pediatric Anesthesiology
- Surgical Innovation
- Global Health
Background:
- Cleft lip and palate (CLP) repair is a common pediatric surgical procedure.
- Safe and accessible anesthesia is crucial, especially in resource-limited settings.
- Halothane anesthesia offers a potential solution for anesthesia delivery in developing countries.
Purpose of the Study:
- To evaluate the safety and efficacy of endotracheal halothane anesthesia for CLP repair in children under 5.
- To assess the feasibility of this anesthetic technique in environments with minimal resources.
- To determine the perioperative complication rate and mortality associated with this approach.
Main Methods:
- A cohort of 350 children under 5 years undergoing CLP repair received endotracheal halothane anesthesia.
- Anesthesia was induced using a mixture of nitrous oxide, oxygen, and halothane via mask.
- Orotracheal intubation was performed without muscle relaxants, maintaining spontaneous respiration.
- Adrenaline infiltration was employed to minimize intraoperative blood loss.
Main Results:
- No life-threatening complications occurred during surgery or the postoperative period.
- The study reported a zero mortality rate in the cohort.
- The technique proved feasible and safe in a setting with limited facilities and resources.
Conclusions:
- Endotracheal halothane anesthesia is a relatively safe and effective anesthetic technique for cleft lip and palate surgery in children.
- This method is particularly suitable for developing countries with minimal healthcare resources.
- The study supports the use of halothane anesthesia for pediatric CLP repair in resource-constrained environments.
Abstract:
Three hundred and fifty children below 5 years of age undergoing surgery for repair of cleft lip and palate received endotracheal halothane anaesthesia. For induction of anaesthesia a mixture of nitrous oxide (N2O), oxygen (O2) and halothane was given by mask. Orotracheal intubation was carried out without administration of relaxants and spontaneous respiration was maintained. Adrenaline infiltration was used to minimise the blood loss. No life-threatening complications were seen during surgery or in the post-operative period. The mortality in this group was zero. The study showed that anaesthesia for cleft lip (CL) and cleft palate (CP) surgery could be given relatively safely in developing countries where facilities and resources available are minimal.