NEONATAL CLEFT-LIP REPAIR A RETROSPECTIVE REVIEW OF ANESTHETIC COMPLICATIONS

A retrospective analysis of the first 50 cases of neonatal cleft lip r epair performed at the Hospital for Sick Children is presented. The pa tient population included 11 expremature infants of less than 45 weeks postconceptual age. There was no mortality at the time of follow-up. There was one case of peroperative hypoxaemia. There was one case of p ostoperative laryngospasm requiring reintubation. Postoperatively ther e were four cases of mild hypoxaemia and one patient with transient ap noea. No patients required blood transfusion. Seventy-six percent of p atients did not require opioid analgesia. The remainder received a sin gle dose of intramuscular codeine phosphate. The advantages and risks of anaesthesia for cleft lip in the neonatal period are reviewed. Reco mmendations for safe practice include the selection of gestationally m ature infants with no intercurrent illness, avoidance of opioid analge sia, adequate staffing ratios of experienced postoperative nursing car e, appropriate monitoring including oximetry and apnoea detectors.