Anesthetic Exposure in Staged Versus Single-Stage Cleft Lip and Palate Repair: Can We Reduce Risk of Anesthesia-Induced Developmental Neurotoxicity?
| Autor: | Armando A Davila, Jeremy Kubiak, Stephanie W Holzmer, Mark C. Martin |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Anesthesia
Dental Cleft Lip Population Neuronal toxicity 03 medical and health sciences 0302 clinical medicine Palate repair Medicine Humans Single institution 030223 otorhinolaryngology education Anesthetics Retrospective Studies Developmental neurotoxicity Retrospective review education.field_of_study business.industry Single stage Infant 030206 dentistry General Medicine Cleft Palate Otorhinolaryngology Anesthesia Anesthetic Surgery business medicine.drug |
| Zdroj: | The Journal of craniofacial surgery. 32(2) |
| ISSN: | 1536-3732 |
| Popis: | Cleft lip and palate (CLP) repair is typically performed in a staged fashion, which requires multiple instances of anesthetic exposure during a critical period of infant neurodevelopment. One solution to this concern includes the implementation of a single-stage CLP repair performed between 6 and 12 months of age. This study aimed to compare total anesthetic exposure between single-stage and staged CLP repairs. A retrospective review of unilateral CLP repairs between 2013 and 2018 conducted at a single institution was performed. Patients underwent either traditional, staged lip and palate repair, or single-stage complete cleft repair, where palate, lip, alveolus, and nasal repair was performed simultaneously. Primary endpoints included: total surgical time and total anesthetic exposure. Secondary endpoints included: excess anesthesia time, recovery room time, length of stay, and type of anesthetic administered. Two hundred twenty-five (n = 225) unilateral CLP repairs were conducted at the Loma Linda University. Detailed anesthetic data for eighty-six (n = 86) single-stage and twenty-eight (n = 28) staged operations were available. There was a statistically significant decrease in anesthetic exposure in single-stage versus staged repairs (316 minutes versus 345 minutes, P = 0.017), despite similar procedure times (260 minutes versus 246 minutes, P = 0.224). This resulted in near double excess anesthetic exposure time in the staged group (98 minutes versus 56 minutes, P |
| Databáze: | OpenAIRE |
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