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Anaesthetic management in facial bipartition surgery: The experience of one centre
Author(s) -
Mallory S.,
Yap L. H.,
Jones B. M.,
Bingham R.
Publication year - 2004
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.2004.03529.x
Subject(s) - medicine , surgery , craniofacial , anesthesia , blood transfusion , bradycardia , retrospective cohort study , ventilation (architecture) , heart rate , blood pressure , mechanical engineering , psychiatry , engineering , radiology
Summary Facial bipartition is amongst the most radical craniofacial surgery undertaken but is performed rarely. There is little published information on its anaesthetic management. We undertook a retrospective case‐note review of 22 consecutive patients undergoing bipartition surgery by the same surgical team in one centre in the period 1993–2001. There were incomplete data for two cases and these were therefore excluded. Patients were aged 2 months to 19 years. Conditions treated were facial cleft ( n = 5), frontonasal dysplasia ( n = 7) and facial dysostosis ( n = 8).Intra‐operative complications included major haemorrhage ( n = 4), bradycardia ( n = 3) and unintentional tracheal extubation ( n = 1). There were no peri‐operative deaths. All patients required intra‐operative blood transfusion and 15% of them had a postoperative haemoglobin concentration > 115% of their pre‐operative value. In this series, four patients required postoperative lung ventilation for a median duration of 3 days. Infants < 14 months old were significantly more likely to receive a massive blood transfusion (p = 0.0002), to have an excessively high postoperative haematocrit (p = 0.008) and to require postoperative lung ventilation (p = 0.0002) compared with older patients. We conclude that patients in this age group have a significantly increased risk of postoperative complications.