The role of videolaryngoscopy in cleft surgery: A single center comparative study before and during the COVID-19 pandemic

Abstract

BackgroundCleft lip and palate (CLCP) surgeries necessitate precise airway management, especially in pediatric cases with anatomical variations. The Covid-19 pandemic posed unprecedented challenges to anesthesiology practices that required adaptations to ensure patient safety and minimize viral transmission. Videolaryngoscopy (VL) emerged as a valuable tool in airway management during the pandemic, offering improved intubation success rates and reduced aerosol generation risks. MethodsThis retrospective study compared anesthesiology practices in CLCP surgeries before (2015–2019) and during the Covid-19 (2019–2022) pandemic at a tertiary care center. Patient demographics, anesthesia techniques, intubation difficulty, airway management, and intraoperative and postoperative follow-up were analyzed from anesthesia records. ResultsThis study included 1282 cases. Demographics were similar between periods. During the pandemic, there was a significant decrease in the number of patients under one year old (p < 0.001) and a higher prevalence of micrognathia and comorbidities (p = 0.001 and p = 0.038, respectively). Difficult intubation and intraoperative complication rates decreased during the pandemic, but they were not statistically significant. VL usage during the pandemic contributed to improved extubating success (p < 0.001). ConclusionsVL usage and improved patient outcomes were observed during the pandemic, potentially due to proactive measures and infection control protocols. Decision-making processes for extubation and intensive care unit stay became crucial during the pandemic. Understanding the role of VL and its adaptations during the Covid-19 pandemic is vital for optimizing perioperative care in CLCP surgeries and other procedures requiring airway management. The findings highlight the resilience of healthcare systems and the importance of evidence-based practices under challenging circumstances.