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A Case of APERT SYNDROME with Incomplete cleft palate was posted for palatoplasty.
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| Dr.V. Sankara Subramanian, Consultant Anaesthesiologist, Dr.Jeyashekaran Hospital, Nagercoil |
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Brief Summary
- Baby was full term normal delivery baby
- No H/O of birth asphyxia
- H/o delayed milestones (+)
- H/o epilepsy (+) and was on medications
- Last episode of fits 4 months back
- Congenital hydrocephalus (+), VP shunt procedure done at the age of 5 years
- Age 7 years, Weight – 12.5 Kgs
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Pre operative Assessment
- No verbalisation
- Large Head +
- Syndactyly +
- Macroglossia +
- Micrognathia +
- Maxillary hyperplasia +
- CVS-RS – Clinically normal
- P/A – umbilical hernia +
Anaesthetic Management
- IV line secured with difficulty
- Pre oxygenation done
- Inhalation induction : 6% Sevoflurane+ N2O + O2
- Trial laryngoscopy done, epiglottis visualised
- Induced with PROPOFOL 45 mg, FENTANYL 25 mic
- Orally intubated with 5 size uncuffed RAE tube
- Maintenance N2O + O2 + Atracurium + Sevoflurane
- Intraop – uneventful baby
- Girl extubated on table, smooth postoperative period
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