Predicting Adverse Perioperative Events in Patients Undergoing Primary Cleft Palate Repair

Basta, Marten N.; Fiadjoe, John E.; Woo, Albert S.; Peeples, Kenneth N.; Jackson, Oksana A.

doi:10.1177/1055665617744065

Cited by 17 publications

(42 citation statements)

References 31 publications

(39 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A incidência de complicações respiratórias no intraoperatório de cirurgias eletivas não é claramente reportada na literatura, porém, em se tratando de portadores de fissura, segundo estudo realizado por Desalu et al 8 , essa incidência pode chegar até 38%. As principais complicações reportadas foram extubação inadvertida, laringoespasmo, broncoespasmo e obstrução aguda das vias aéreas 6,7 .…”

Section: Discussionunclassified

“…A via aérea difícil é frequente em portadores de fissura palatina pois, sabidamente, esses pacientes apresentam alterações anatômicas relacionadas às vias aéreas, como descrito em estudos comparativos com pacientes não fissurados 4,5 . Prever esses riscos é crucial para uma boa evolução transoperatória, e a identificação de pacientes com alto risco permite abordagens estratégicas preventivas mais eficazes, alocação de recursos especializados e permite intervenções orientadas 6,7 .…”

Section: Discussionunclassified

“…As complicações respiratórias relacionadas à anestesia são reportadas, na literatura, como fatores que podem aumentar a morbimortalidade 6 . O rápido reconhecimento da situação, a reversão de fatores associados e o tratamento adequado previnem a necessidade de medidas mais invasivas e desfechos desfavoráveis [7][8][9] .…”

Section: Introductionunclassified

See 2 more Smart Citations

Intercorrências anestésicas respiratórias em palatoplastia do paciente fissurado: relato de dois casos

Miranda¹,

Marinho²,

Rodrigues³

et al. 2019

Revista Brasileira De Cirurgia Plástica (RBCP) – Brazilian Journal of Plastic Sugery

View full text Add to dashboard Cite

A anestesia para procedimentos eletivos na cirurgia plástica é, geralmente, muito segura, porém, não está isenta de complicações. O conhecimento e o tratamento efetivo das intercorrências anestésicas são importantes para a segurança do paciente, pois, podem levar ao aumento da morbimortalidade. O paciente portador de fissura labiopalatina necessitará de vários procedimentos cirúrgicos para correções das deformidades e apresenta maior incidência de complicações anestésicas, principalmente respiratórias, comparadas ao paciente não fissurado. Este trabalho tem como finalidade relatar dois casos clínicos de intercorrências respiratórias associadas ao ato anestésico em pacientes fissurados e discutir sobre a importância de prever os riscos, e a necessidade do diagnóstico com tratamento imediato e eficaz.

show abstract

Section: Discussionunclassified

See 1 more Smart Citation

Intercorrências anestésicas respiratórias em palatoplastia do paciente fissurado: relato de dois casos

Miranda¹,

Marinho²,

Rodrigues³

et al. 2019

Revista Brasileira De Cirurgia Plástica (RBCP) – Brazilian Journal of Plastic Sugery

View full text Add to dashboard Cite

show abstract

“…In 2018, a retrospective study was conducted to identify risk factors related to common adverse events in cleft lip and palate surgery; a relationship of adverse events was found with situations such as multiple attempts at intubation, structural or functional abnormality of the airway, surgery greater than 160 minutes, inexperience of the anesthesiologist, high doses of opioids, and no reversal of the neuromuscular blockade [30].…”

Section: Postanesthetic Managementmentioning

confidence: 99%

Anesthesia Considerations in the Perioperative of Patients with Lip and Palate Length

Peña¹,

Reyes²,

Beltran³

et al. 2020

Current Treatment of Cleft Lip and Palate

View full text Add to dashboard Cite

There is a high risk of adverse events during anesthetic management in the pediatric population mainly in children under 1 year of age and with greater vulnerability: those undergoing head and neck surgery for involving airway, specifically patients who enter surgical correction of the lip and cleft palate. This pathology can be related in a high percentage to isolated malformations without integrating a specific syndrome or be part of the more than 500 associated craniofacial syndromes such as sequence Pierre Robin, Treacher Collins, and Goldenhar, among others; it is also associated in up to 10% with some heart disease. Factors that are determinants for anesthetic management have been identified in corrective surgery of the lip and cleft palate related to the patient's characteristics such as age and weight, his medical history or associated comorbidities, and the surgical technique. As it is the pathology with the highest incidence in facial malformations that requires surgical treatment, it is necessary to know the anesthetic management alternatives and establish criteria in the different stages of the perioperative period from preanesthetic assessment to postanesthetic care, in order to provide planned approach within the highest safety standards that reduce the risk of adverse events.

show abstract

“…Patients with isolated RS and RS with associated syndromes present to the operating room throughout childhood for craniofacial reconstructions, ear, nose, and throat operations, dental restorations, and other surgeries. Direct laryngoscopy in children with RS is typically difficult 6‐8 and the rate of perioperative adverse airway events is high 9,10 . Patients with RS are at high risk for experiencing perioperative complications, including failed intubation, hypoxemia, dyspnea, failed extubation and prolonged intubation, and mechanical ventilation 11 …”

Section: Introductionmentioning

confidence: 99%

Longer upper airway lengths in Robin Sequence: A case‐control study using computed tomography

Perez

Hottinger

Evans

et al. 2020

Pediatric Anesthesia

View full text Add to dashboard Cite

Background Direct laryngoscopy and intubation are often difficult in children with Robin Sequence. Previous research characterizing anatomic airway differences has focused on parameters influencing airway patency; there is a paucity of data pertaining to intubation trajectories and depth. Such information could impact airway management approaches and decrease the incidence of endotracheal tube malpositioning. Aim The study goal was to examine whether longitudinal airway parameters pertaining to intubation are different in children with Robin Sequence compared with age‐matched controls. Method This case‐control study compared patients with RS <4 years of age who had computed tomography scans of the head and neck to age‐ and sex‐matched controls. Measurements were made of the nasopharynx, oropharynx, hypopharynx, tongue, hyoid, and the front teeth to vocal cord, nares to vocal cord, and nasion‐basion distances. Statistical analysis was performed using multiple ANCOVA models with the categorical predictor of Robin Sequence vs control and potential covariates including subject height/length, weight, and age. Results Thirty‐three patients with Robin Sequence and 33 control subjects were included. After controlling for subject height/length, mean front teeth to vocal cord distance was 1.2 cm longer (95% CI: 0.9 to 1.6 cm, P < .001) and mean nares to vocal cord distance was 0.8 cm longer (95% CI: 0.4 to 1.2 cm, P < .001) in patients with Robin Sequence than in controls. The tongue was positioned on average 0.5 cm higher (95% CI: 0.3 to 0.8, P < .001) and 0.9 cm more posterior (95% CI: 0.6 to 1.0 cm, P < .001) in cases than in controls. Moreover, in patients with Robin Sequence, the hyoid was positioned on average 0.5 cm more inferiorly (95% CI: 0.2 to 0.8 cm, P < .001) and 0.2 cm more posteriorly (95% CI: 0.1 to 0.4 cm, P < .01) than controls. Conclusion In patients with Robin Sequence under 4 years of age, the mean front teeth to vocal cord distance was found to be 1.2 cm longer while the mean nares to vocal cord distance was found to be 0.8 cm longer controlling for subject length. Clinicians should account for these differences when selecting and placing endotracheal tubes, particularly those with a preformed bend.

show abstract

Predicting Adverse Perioperative Events in Patients Undergoing Primary Cleft Palate Repair

Abstract: APE incidence was 23.0% after palatoplasty, with a 37-fold higher incidence in extreme-risk patients. Individualized risk assessment tools may enhance perioperative clinical decision making to mitigate complications.

Cited by 17 publications

References 31 publications

Intercorrências anestésicas respiratórias em palatoplastia do paciente fissurado: relato de dois casos

Intercorrências anestésicas respiratórias em palatoplastia do paciente fissurado: relato de dois casos

Anesthesia Considerations in the Perioperative of Patients with Lip and Palate Length

Longer upper airway lengths in Robin Sequence: A case‐control study using computed tomography

Contact Info

Product

Resources

About