title: Anesthetic challenges in oro-facial cleft repair in Ile-Ife, Nigeria.
abstract: METHODS
  A retrospective review of all patients with oro-facial lip defects operated at the Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria over an 18 month period was undertaken with a view to determine: the pattern of presentation; associated clinical problems and congenital anomalies; perioperative complications; anaesthetic techniques used and outcomes; and the determinants of outcome.
  
  
  RESULTS
  Of the 80 patients treated, 74 were managed under general anaesthesia but the case records of only 60 (81%) of these patients were available for review. The ages ranged between 3 months and 59 years. The male to female ratio was 1:1. Eighty percent of all cases studied were cleft lip (CL) +/- cleft palate (CP). Of these, 65% were left sided CL, 23% were right sided while 12% were bilateral. All patients had ASA score 1 or 2 at the time of surgery. Halothane in O2 induction was employed in 60% of the patients while 40% had IV induction. Intubation was facilitated with muscle relaxant in 63.3% of these patients. Naso-tracheal intubation was performed in 82% of all cleft palate repairs. Preoperative complications were encountered in 18% of the patients. Associated congenital anomalies were noted in 5% of the cases. One case each of difficult intubation and failed intubation were encountered. Intra-operative dysrrhythmia was noted in 5% of cases; no life-threatening complication was encountered peri-operatively.
  
  
  CONCLUSIONS
  There is a dramatic increase in the number of patients presenting for care due to improved awareness of the population. Peri-operative attention to detail is essential in handling the challenges posed by the condition.
authors.affiliation: Department of Anaesthesia, Obafemi Awolowo University, Ile-Ife, Nigeria. tonieadenekan@yahoo.com
authors.forename: Anthony Taiwo
authors.initials: AT
authors.lastname: Adenekan
authors.forename: Aramide Folayemi
authors.initials: AF
authors.lastname: Faponle
authors.forename: Fadekemi Olufunmilayo
authors.initials: FO
authors.lastname: Oginni
mesh_terms: D000015:Abnormalities, Multiple; D000293:Adolescent; D000328:Adult; D000758:Anesthesia; D018685:Anesthetics, Inhalation; D001145:Arrhythmias, Cardiac / Q000188:drug therapy / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D002971:Cleft Lip / Q000601:surgery*; D002972:Cleft Palate / Q000601:surgery*; D005260:Female; D006221:Halothane; D006801:Humans; D007223:Infant; D007431:Intraoperative Complications / Q000188:drug therapy / Q000453:epidemiology; D007442:Intubation, Intratracheal; D008297:Male; D008875:Middle Aged; D009549:Nigeria; D011229:Preanesthetic Medication; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D018685:Anesthetics, Inhalation; D006221:Halothane