Anaesthesia for drooling surgery

SummaryDrooling of saliva is an important problem in patients with neurodevelopmental disabilities. A multidisciplinary approach is essential for the management of drooling in these patients. Modalities of treatment include correction of reversible causes, behavioural modification, anticholinergic agents, botulinum toxin injection, laser photocoagulation of salivary ducts and surgical therapy. Surgery is considered in patients not responding to conservative management. pre-operative evaluation is aimed at assessing the severity of the underlying neurologic disorder, multisystemic involvement and concurrent medications with anaesthetic implications. Titration of anaesthetic agents is important in the intraoperative period as drug response and requirements vary in these patients. Vigilance during extubation and immediate postoperative period is critical to prevent respiratory complications and ensuring a successful outcome.