Assessing the Safety of a Novel Neonatal Anesthesia Protocol: A Review of 101 Patients With Early Cleft Lip Repair. Issue 8 (9th November 2021)

• Record Type: Journal Article
• Authors: Wlodarczyk, Jordan R.; Higuchi, Emma C.; Liu, Alice; Urata, Marcus M.; Gabreel, Waleed; Wolfswinkel, Erik M.; Lau, Jennifer; Matar, Marla; Magee, William P.; Urata, Mark M.; Hammoudeh, Jeffrey A.
• Is Part Of: Journal of craniofacial surgery. Volume 32:Issue 8(2021)
• Page Start: 2682
• Page End: 2686
• Publication Date: 2021-11-09
• Subjects: Anesthesia -- cleft lip -- early cleft repair -- non-volatile anesthetic based anesthesia -- rule of 10's; Facial bones -- Surgery -- Periodicals; Skull -- Surgery -- Periodicals; Face -- Surgery -- Periodicals; Surgery, Plastic -- Periodicals; 617.52
• DOI: 10.1097/SCS.0000000000007964
• Languages: English
• ISSNs: 1049-2275

Abstract

Abstract : Supplemental Digital Content is available in the text Abstract : Purpose: Our study introduces a novel anesthetic protocol for neonates without using volatile agents with the goal to minimize potentially neurotoxic and pro-apoptotic agents. The authors evaluated the short-term safety and efficacy of our anesthetic protocol in patients undergoing early cleft lip repair (ECLR). Methods: A retrospective review of ECLR patients who underwent repair before 2.5 months of age within the last 4.3 years was performed. This sample was comprised of 2 groups, those who received either a standard volatile gas-based regimen or a dexmedetomidine-based neonatal anesthetic protocol (DBNAP). Patient demographics, medication dosing, anesthetic time (induction to extubation), major and minor complications, and medication side effects were compared between the 2 cohorts. Results: A total of 101 patients underwent ECLR. All patients were American Society of Anesthesiologists class 1 or 2. Mean age at surgery was 31 ± 13 days and mean anesthetic time was 179 ± 36 minutes. DBNAP was used in 65 patients while the standard anesthetic protocol was used in 36 patients. Patient weight was significantly lower in the DBNAP group (4.01 ± 0.61 versus 4.38 ± 0.72 kg, P = 0.007). There were no significant differences between the 2 cohorts when comparing anesthetic time, emergence time, complication rate, or medication side effects. Conclusion: For patients undergoing ECLR, DBNAP is perioperatively equivalent to the anesthetic standard of care, demonstrating no major complications and acceptable rates of minor complications and medication side effects.