Prise en charge anesthésique pour chirurgie de fentes labio-palatines chez l'enfant

Cleft lip and palate is one of the most common craniofacial abnormalities in children, associated or not with a genetic syndrome. It requires early surgery in the first months of life. Surgical procedures convey a significant risk of upper airway obstruction and respiratory depression, aggravated by the administration of opioids for analgesia during and after surgery. Pre-anaesthetic consultation is critical to check for polymorphism abnormalities associated with airway obstruction or episodes of hypoxemia. During anaesthesia, the main difficulty lies in the airway management with the risk of difficult intubation and displacement of the endotracheal tube secondary to the mobilization of the head during surgery. Postoperative pain is severe and lasts for 24 to 48 hours. Pain management uses opioid analgesics in most cases. However, regional anaesthesia is valuable in terms of pain relief and opioid sparing effect. There are risks of respiratory complications and endobuccal bleeding.