Anaesthesia in Congenital Facial Anomalies in a Rural Set up of a Developing Country
Background: India has an estimated backlog of 1000000 cleft patients. A total of 35000 new cleft patients are born each year. With the capacity to operate on approximately 50000 patients each year only 15000 patients from the national backlog can be operated upon each year if capability is not...
Main Authors: | , , , , , |
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Format: | Article |
Language: | English |
Published: |
Krishna Institute of Medical Sciences University
2015-01-01
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Series: | Journal of Krishna Institute of Medical Sciences University |
Subjects: | |
Online Access: | http://jkimsu.com/jkimsu-vol4no3/JKIMSU,%20Vol.%204,%20No.%203,%20July-Sept%202015%20Page%2017-23.pdf |
Summary: | Background: India has an estimated backlog of
1000000 cleft patients. A total of 35000 new cleft
patients are born each year. With the capacity to
operate on approximately 50000 patients each year
only 15000 patients from the national backlog can be
operated upon each year if capability is not augmented.
Objectives: To reach the population at large we
meticulously planned an out-reach programme and
operated on patients even in rural set ups with lack of
modern facilities. We operated on patients at sub
divisional centres, where apparatus for providing
sevoflurane was not available. Institutional Ethical
clearance was taken before conduction of the study.
Patients who required prolonged surgery were taken to
the tertiary centre. Working ventilators were also not
available at peripheral centres. Materials and
Methods: This interventional study was carried in a
time span of four years on nineteen hundred and nine
patients, after taking approval from the Institutional
Ethical Committee. Patients were screened and some
were operated at rural centers and others at a tertiary
care centre. Patients who could not afford to come to
the tertiary care centre were operated at different rural
centers. Informed consent was taken. Results: There
were 1909 patients with Congenital Facial Anomalies
(CFA) over four years period out of which 918 patients
were of either unilateral or bilateral cleft lip. They were
successfully operated at rural health centers with
limited facilities. This could reduce the total load of
surgeries for CFA at tertiary care hospital ensuring safe
surgeries for all with CFA for all age groups and both genders.No mortality was recorded and post operative
complications consisted of nausea and vomiting, three
had delayed recovery and one had laryngospasm.
Conclusion: Outreach programmes can increase the
efficacy of Smile Train Project and effective screening
of patients before surgery can result in fruitful
outcomes even in a rural set up with lack of modern
anaesthetic facilities. |
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ISSN: | 2231-4261 2231-4261 |