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KMID : 0378019690120100079
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New Medical Journal
1969 Volume.12 No. 10 p.79 ~ p.84
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The Clinical Survey of General Anesthesia on the Cleft Lip and Palate of 317 Cases
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朴東浩/Park, Dong Ho
李春熙/黃淸子/金?植/Lee, Choon Hee/Whang, Chung Za/Kim, Wan Sik
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Abstract
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This is a clinical survey of 317 cases of general anesthesia for cleft lip and cleft palate between 1961 and 1968 at Yonsei Univ. Medical Center in Seoul, Korea.
I. The number of case: There was no great difference between cleft lip with cheiloalveoloplasty (58. 7%) and cleft Palate with pharyngeal flap(41.3%). (Table 1)
2. Sex and age: Here implicated with social problems of Korea. Related to Korean traditional thinking, there was a tendency for increase of operation in the early period(from 5 days to under 10 yrs.) in males On the other hand, there was an absolutely opposite phenomena in females (from 10yrs. to 30 yrs) (Table2)
3. Time of operation and anesthesia: Most were one or two hour operations (64.7%), but there was a tendency toward more than 20 to 30 minutes longer anesthesia (67.8%). (Table 3)
The reasons why the operation and anesthesia were prolonged are as follows.
a. Premedication: The ideal response with the use of premedicants followed barbiturates and atropine in children, and further barbiturates, narcotics with atropine in adults, (Table 4)
b. Inhalation anesthetics: From the point of view of induction, maintenane and recovery, group 6,7, 8,9 (Pentothal, succinylcholine, ether with nitrous oxide mixture) have had a better response compared with other groups. (Table 5)
c. Technics: In pediatric anesthesia, the non-rebreathing system with a Stephen or Ruben valve comprised more than 80% and the endotracheal anesthesia was 18.5% in adults. (Table 6)
d. Operative- equipment: Mainly a Dott´ s mouth gag with a Sorensen tongue blade was used in palatoplasty cases.
4. Post-operative complications(12 cases).
In cheiloplasty, 9 cases(2. 8%) were present with wound infection 2, stitch abscess 5, subcutaneous ecchymosis 1, fistula 1.
In palatoplasty, 3cases (0. 9%) were present with wound infection 2, and post-operative bleeding 1. (Table 7)
Generally, admission was for 7 to 8 days in cheiloplasty and 14 to 16 days in palatoplasty.
5. The Anatomical congenital malformations were checked during anesthesia and operation. Localized tongue tie (4 cases) and micrognathia(2 cases) were present. (Table, 8)
Acknowledgement
I wish to acknowledge with thanks the assistance of Prof. J.D. Lew and Instructor J. S. Park of the Dept. of Plastic Surg. and of all residents, Dept. of Anesthesiology in the preparation of this paper.
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