Impact of perioperative circumstances on postoperative respiratory complications in cleft lip and palate patients undergoing palatoplasty

The safety of pediatric surgery in cleft patients is an important topic, since complication rates can be influenced by many factors. The aim of this study was to evaluate perioperative factors and their influence on postoperative respiratory events in cleft lip and palate patients undergoing palatoplasty. The study included healthy patients (ASA I and II) with unilateral and bilateral cleft lip and palate and isolated cleft palate (n = 52) undergoing palatoplasty at the age of 390 (130) days, with a medium cleft palate size of 8 (8) mm. One group with respiratory complications (RC: n = 7) and a second group with no complications (NC: n = 45) were compared regarding perioperative factors, such as preoperative blood values and intraoperative course (temperature, blood pressure (RR), O₂ saturation and operation time). A total complication rate of 13.5% was observed. None of the examined factors was significant. However, the fact that the RC group had a longer total anesthesia time could point to a possible cause or contributing factor. Since the working field of the anesthesiologist changes during the operation, we recommend a clear interdisciplinary collaboration between surgeons and anesthesiologists, and keeping operation times as short as possible.