Anaesthesia in Cystic Fibrosis,Plastic Surgery General Principles

4th Pediatric Infectious Diseases Conference

ISSN 0973 - 0958

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ANESTHESIA AND ASSOCIATED DISEASES

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Anaesthesia General Principles

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Cleft lip and Palate And Cystic Hygroma

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Dr Sunita Goel
Lecturer in Anaesthesiology
BJ Wadia Children's Hospital

Cystic fibrosis:

Cystic fibrosis is an autosomal disorder. It affects many body systems including the lungs; respiratory failure develops by the 2nd /3rd decade of life.

Special anesthetic problems:

Copious, extremely viscous secretions in the respiratory tract
Because of the V/Q disturbances;
- Hypoxia may develop rapidly during anesthesia.
- Induction of anesthesia with inhalational agents is prolonged.
Increased lung compliance. In the severe late cases, very high airway pressure may be required to provide adequate ventilation and prevent hypoxemia. Therefore use a cuffed ETT or bronchoscope, whenever possible.
Many children having advanced cystic fibrosis become severely emotionally upset. All of them require especially careful and considerate handling and much reassurance.

Plastic Surgery:

General Principles:

Many of these children have psychological upsets stemming from both the deformity and multiple surgical procedures. Thus a very careful considerate approach by the anesthesiologist is essential.
Smooth general anesthesia with quiet emergence lessens the risk of damage to the grafted areas and delicately sutured repairs.
Many patients requiring plastic surgery have potentially serious airway problems that require careful assessment and special management.
Congenital structural anomalies commonly affect more than one body system. If congenital heart disease is present, ensure that the child is given prophylactic antibiotic therapy pre-operatively.

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