This article presents two cases of amniotic band syndrome associated with orofacial deformities. There was an uncommon presentation in one of them as Tessier nos. 5, 7 and 30 with irregularly distributed amniotic facial band. The surgical repair of the facial clefts and difficulties in overall management in our environment are further discussed.

Introduction Cleft lip and palate is one of the more common congenital malformation and the most common craniofacial anomalies in children. The treatment is expensive and requires specialised care. Access to this care in middle and low income countries is compounded by socioeconomic status of patients and their relation and also the inadequacy of expertise in medical personnel and infrastructure. Objective: the study aimed to review the techniques of anaesthesia used in a low resource setting in terms of the techniques, outcome, and safety. Methods This is a retrospective review of 79 cases done in a resource poor setting. Information regarding the patients, surgeries and modes of anaesthesia were retrieved from the case notes. Results A total of 62 patients were operated with incomplete cleft accounting for 37 (59.7%), complete 23(37.1%), and 2 (3.2%) as bilateral. Forty-six (74.2%) of patients had their surgery done with ketamine anaesthesia without endotracheal intubation, 14 (22.6%) had regional anaesthesia and 2 patients (3.2%) had general anaesthesia with endotracheal intubation. Conclusion This study demonstrates that with careful planning and expertise, cleft lip repair can be done safely in resource poor setting.

Objective: A majority of minor oral surgical procedures require the use of local anaesthetics containing vasoconstrictors as part of the composition. These vasoconstrictors cause some hemodynamic changes either by direct action on the cardiac muscle or by stimulation of the autonomic innervations of the heart. Depending on the concentration of the vasoconstrictor, an increased heart rate, increased force of cardiac contraction, and ultimately increased blood pressure may ensue. The aim of this study was to assess the effect of vasoconstrictors contained in local anaesthetics on arterial blood pressure during minor oral surgical procedures. Material and Methods: This was a one year prospective, randomized, comparative study involving the assessment of blood pressure and pulse rate by using an electronic digital blood pressure monitoring device amongst consenting patients who were referred for tooth extraction. The potential research participants were randomly allocated into either the study or the control group. The study group was treated using 2% lignocaine with 1:80,000 epinephrine, while the control was treated using 2% plain lignocaine (without epinephrine). Normal or controlled-hypertensive patients between the ages of 18 to 55 years were enrolled into the study. Results: A total of 100 subjects with a mean age of 34.66±10.3 years participated in the study. There was no statistically significant difference in blood pressure and pulse rate between the patients in both the study group and control group. Conclusion: Optimal use of adrenaline-containing local anaesthetic does not cause a statistically significant increase in blood pressure or pulse rate.

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