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J Plast Reconstr Aesthet Surg ; 94: 98-102, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38776628

RESUMEN

BACKGROUND: Cleft lip and palate (CLCP) surgeries necessitate precise airway management, especially in pediatric cases with anatomical variations. The Covid-19 pandemic posed unprecedented challenges to anesthesiology practices that required adaptations to ensure patient safety and minimize viral transmission. Videolaryngoscopy (VL) emerged as a valuable tool in airway management during the pandemic, offering improved intubation success rates and reduced aerosol generation risks. METHODS: This retrospective study compared anesthesiology practices in CLCP surgeries before (2015-2019) and during the Covid-19 (2019-2022) pandemic at a tertiary care center. Patient demographics, anesthesia techniques, intubation difficulty, airway management, and intraoperative and postoperative follow-up were analyzed from anesthesia records. RESULTS: This study included 1282 cases. Demographics were similar between periods. During the pandemic, there was a significant decrease in the number of patients under one year old (p < 0.001) and a higher prevalence of micrognathia and comorbidities (p = 0.001 and p = 0.038, respectively). Difficult intubation and intraoperative complication rates decreased during the pandemic, but they were not statistically significant. VL usage during the pandemic contributed to improved extubating success (p < 0.001). CONCLUSIONS: VL usage and improved patient outcomes were observed during the pandemic, potentially due to proactive measures and infection control protocols. Decision-making processes for extubation and intensive care unit stay became crucial during the pandemic. Understanding the role of VL and its adaptations during the Covid-19 pandemic is vital for optimizing perioperative care in CLCP surgeries and other procedures requiring airway management. The findings highlight the resilience of healthcare systems and the importance of evidence-based practices under challenging circumstances.


Asunto(s)
COVID-19 , Labio Leporino , Fisura del Paladar , Laringoscopía , Humanos , COVID-19/prevención & control , COVID-19/epidemiología , Laringoscopía/métodos , Estudios Retrospectivos , Masculino , Femenino , Fisura del Paladar/cirugía , Labio Leporino/cirugía , Lactante , Preescolar , Intubación Intratraqueal/métodos , Manejo de la Vía Aérea/métodos , Niño , SARS-CoV-2 , Cirugía Asistida por Video/métodos
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