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An Analysis of Unplanned Intraoperative Extubation in Cleft Lip and Palate Repair

Aidin Gharavi1, Jainaha K Srikumar2, Dawit Haile3

  • 1Mayo Clinic Alix School of Medicine, Rochester, MN, USA.

The Cleft Palate-Craniofacial Journal : Official Publication of the American Cleft Palate-Craniofacial Association
|October 30, 2025
PubMed

Insights

Unplanned intraoperative extubation (UIE) during pediatric cleft lip and cleft palate repair is rare. This event did not lead to increased postoperative complications in children.

Area of Science:

  • Pediatric Surgery
  • Anesthesiology
  • Health Outcomes Research

Background:

  • Unplanned intraoperative extubation (UIE) is a rare event in pediatric surgery.
  • Cleft lip (CL) and cleft palate (CP) repairs are common pediatric procedures with specific anesthetic considerations.

Purpose of the Study:

  • To investigate the incidence and characteristics of UIE in pediatric patients undergoing CL and CP repair.
  • To assess the association between UIE and 30-day postoperative complications.

Main Methods:

  • Retrospective cohort study utilizing the 2019-2023 National Surgical Quality Improvement Program-Pediatric database.
  • Analysis of demographic, operative characteristics, and postoperative outcomes for children undergoing CL (<1 year) and CP (<3 years) repair.

Main Results:

  • UIE occurred in 0.37% of CL repairs and 0.20% of CP repairs.
  • Patients with UIE had similar baseline characteristics but longer operative and anesthesia times.
  • No deaths, pneumonia, or unplanned reintubations were observed postoperatively; overall complication rates remained low.

Conclusions:

  • UIE during pediatric CL and CP repair is an infrequent occurrence.
  • UIE in this context is not associated with significant major postoperative complications.

Keywords:
cleft lipcleft palatepediatricsquality improvementsurgical complications

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