Anaesthetic aspects for cleft lip surgeries in babies
When to start Cheiloplasty or cleft lip repair?
Cheiloplasty or cleft lip repair is done at our Richardsons dental and craniofacial Hospital when the baby attains 5kgs weight which is usually around 3 months of age. It is at this time that the baby is amenable to operation under general anaesthesia with better pre-operative control.
anaesthetic preperations before cheiloplasty infograpic image
Pre-operatively the baby is assessed by the consultant paediatric anaesthesiologist focussing on the airway, anaemia, allergies, cardiovascular and for other abnormalities. Blood investigations for haemoglobin, complete blood count etc is done.
Baby is kept fasting as below:
clear fluids: 2 hours
breastfeed: 4 hours
formula feed: 6 hours
After keeping everything ready in the OT, the baby is shifted to the OT. Monitors like ECG, SPO2, EtCO2, precardial stethoscope are attached.
the baby is induced with sevoflurane which is a volatile anaesthetic agent. It causes minimal discomfort to the patient. A special RAE tube is used to secure the airway and breathing is controlled by the anaesthesia machine.
After the procedure, the nasal airway is inserted to support breathing if needed. The feeding for the baby is started after two hours.