Anaesthesia for cleft lip and palate surgery

Somerville, Nicola; Fenlon, Stephen

doi:10.1093/bjaceaccp/mki021

Cited by 19 publications

(12 citation statements)

References 5 publications

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“…Many authors tried several solutions to overcome the difficulties in airway management in bilateral cleft palate patients; Kumar et al . described the use of winged laryngoscopy in intubation of 35 pediatric patients with left, right unilateral or bilateral cleft palate.…”

Section: Discussionmentioning

confidence: 99%

“…However, in patients with bilateral cleft lip and palate, the incidence of difficult laryngoscopy has been reported to be 16.5–45.8% . In infants with bilateral clefts of the lip and alveolus with protruding premaxilla, laryngoscopy is difficult because the blade has a tendency to sink in the cleft and may lead to iatrogenic tissue trauma.…”

Section: Introductionmentioning

confidence: 99%

“…Difficult airway management in uncorrected cleft palate patients has been studied by many authors . Xue et al .…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

A novel intubation technique in bilateral cleft palate pediatric patients: hard gum shield–aided intubation

Mahmoud

Fouad

Mansour

et al. 2012

Pediatric Anesthesia

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A novel intubation technique in bilateral cleft palate pediatric patients: hard gum shield–aided intubation

Mahmoud

Fouad

Mansour

et al. 2012

Pediatric Anesthesia

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“…Cleft lip (CL) may be reliably diagnosed at the 18-20 weeks during anomaly scan; however, it is extremely difficult to visualize cleft palate (CP) prior to delivery. [ 5 ] Many classifications have been devised, but essentially the cleft can involve the lip, alveolus (gum), hard palate, and/or soft palate and can be complete or incomplete, unilateral or bilateral.…”

Section: Embryologymentioning

confidence: 99%

Postoperative analgesia for cleft lip and palate repair in children

Reena

Bandyopadhyay

Paul

2016

J Anaesthesiol Clin Pharmacol

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Acute pain such as postoperative pain during infancy was ignored approximately three decades ago due to biases and misconceptions regarding the maturity of the infant's developing nervous system, their inability to verbally report pain, and their perceived inability to remember pain. More recently, these misconceptions are rarely acknowledged due to enhanced understanding of the developmental neurobiology of infant pain pathways and supraspinal processing. Cleft lip and palate is one of the most common congenital abnormalities requiring surgical treatment in children and is associated with intense postoperative pain. The pain management gets further complicated due to association with postsurgical difficult airway and other congenital anomalies. Orofacial blocks like infraorbital, external nasal, greater/lesser palatine, and nasopalatine nerve blocks have been successively used either alone or in combinations to reduce the postoperative pain. Since in pediatric population, regional anesthesia is essentially performed under general anesthesia, association of these two techniques has dramatically cut down the risks of both procedures particularly those associated with the use of opioids and nonsteroidal anti-inflammatory drugs. Definitive guidelines for postoperative pain management in these patients have not yet been developed. Incorporation of multimodal approach as an institutional protocol can help minimize the confusion around this topic.

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“…In infants with bilateral clefts of the lip and alveolus with protruding premaxilla, laryngoscopy is difficult because the blade has a tendency to sink in the cleft (4) and may lead to iatrogenic tissue trauma. Till date, there are no reports of the use of videolaryngoscopes with oxygenation facility for easing difficult laryngoscopy in patients with cleft lip and palate.…”

mentioning

confidence: 99%