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KMID : 0878619990030020082
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Korean Journal of Pediatric Anesthesia
1999 Volume.3 No. 2 p.82 ~ p.86
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Clinical Analysis of Anethesia for 214 Cases with Cleft Lip and/or Palate in Children
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Choi Jeong-Hwan
Ryu Kyung-A
Moon Se-Ho
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Abstract
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Background: Cleft lip, either with or without cleft palate, is one of the most common congenital malformations in Korea. Careful anesthetic management is needed during preoperative, perioperative and postoperative periods due to congenital anomaly, respiratory infection, aspiration and feeding difficulties.
Methods: A retrospective analysis was done on 214 pediatric patients with cleft lip and/or palate at St. Mary’s Hospital, Catholic University from January 1, 1995 to April 31, 1999.
Results: 1) The incidence of cleft lip was 58 cases (27.1%); cleft palate, 53 cases (24.8%); cleft lip with palate, 103 cases (48.1%). The incidence of cleft lip was 2.2 times higher in male, and 1.8 times higher in the case of cleft lip with palate, but cleft palate affected female 2.1 times more than male. 2) Cheiloplasty was performed on most of patients in less than 6 months (78%), and patients received palatoplasty in one to two years (76.1%). 3) Family history was found in 11 cases (5.1%), 7 cases of which were father related, and 4 cases mother related. 4) Forty cases (18.6%) had a history of medication and radiation during early pregnancy. 5) The incidence of associated anormalies was 17 cases (7.9%), and congenital heart disease was the most frequent (6 cases). 6) Respiratory diseases were found in 28 cases, and middle ear diseases were found in 62 cases. 7) The duration of anesthesia and the amount of fluid were 125±30.8 minutes and 65.1±48.4 ㎖ in cheiloplasty, 148.1±33.3 minutes and 83.3±51.6 ㎖ in cheiloplasty with maxillary impression, and 160.9±36.4 minutes and 137.5±91.3 ㎖ in palatoplasty respectively. 8) Postoperative complications developed in 11 cases (5.1%), including acute gastroenteritis (5 cases), acute pharyngitis (2 cases), bronchopneumonia (2 cases) and others (3 cases), and inadvertent extubation occurred in 4 cases during operation.
Conclusions: With careful preoperative evaluation of the status of the airway, respiratiry diseases, congenital anormalies and close communication between the anesthesiologist and the surgeon, anesthesia during cheiloplasty and palatoplasty can be worthwhile.
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KEYWORD
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Anesthesia: pediatric, Surgery: cleft lip, cleft palate
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