The role of videolaryngoscopy in cleft surgery: A single center comparative study before and during the COVID-19 pandemic

J Plast Reconstr Aesthet Surg. 2024 Jul:94:98-102. doi: 10.1016/j.bjps.2024.04.062. Epub 2024 Apr 30.

Abstract

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.

Keywords: Anesthesia; COVID-19 pandemic; Cleft lip and palate surgery; Videolaryngoscopy.

Publication types

  • Comparative Study

MeSH terms

  • Airway Management / methods
  • COVID-19* / epidemiology
  • COVID-19* / prevention & control
  • Child
  • Child, Preschool
  • Cleft Lip* / surgery
  • Cleft Palate* / surgery
  • Female
  • Humans
  • Infant
  • Intubation, Intratracheal / methods
  • Laryngoscopy* / methods
  • Male
  • Retrospective Studies
  • SARS-CoV-2
  • Video-Assisted Surgery / methods