Cleft lip repair under local anaesthesia: experience in two tertiary hospitals in Nigeria

Abstract

Introduction : Time and costs are saved performing procedures (where applicable) under local anaesthesia. Some patients refuse surgery for fear of general anaesthesia. Indeed local anaesthesia is preferred over general anaesthesia where practicable, but lip repair is commonly done under general anaesthesia. Some surgeons carry out cleft lip repair under local anaesthesia even in paediatric age group. However, only few reports on the actual technique and experience are available from this sub region. Materials and methods : A retrospective study of lip repairs done under local anaesthesia from September 2004 to June 2009 is presented. Theatre records were reviewed; excluded were all patients who had ketamine premedication, and patients who had only a touch up for a notch. Following conscious sedation, 2% lignocaine in (1 in 50 000) adrenaline solution was infiltrated at the cleft margins and the procedure carried out. Results: Forty patients were studied, 31 from the first centre and 9 from the second. All were day procedures, no readmissions for any reasons were noted and no wound infection. One revision of a resultant notch following repair with local anaesthesia was done. No patient declined surgery in the period and all returned for palatoplasty where the palate was involved. Conclusion : Local anaesthesia is safe, cost saving, improves compliance and acceptable in Nigeria for cleft lip repair.