Our Summary
This research paper investigates the problem of “emergence agitation” (EA) in children who have just had surgery for a cleft lip or palate. EA refers to a state of confusion, restlessness, or uncontrollable behavior that can happen after general anesthesia. It’s a common issue that often covers up signs of oxygen deprivation, a serious complication that can occur immediately after surgery.
The study involved 214 patients aged between 3 months and 6 years at a specialized dental hospital. The researchers assessed each patient’s level of agitation at three points: when they first entered the recovery room (PACU), while they were in the recovery room, and when they left the recovery room.
The results showed that almost 70% of patients exhibited significant agitation when they first entered the recovery room, around 40% were agitated while in the recovery room, and over 20% were still agitated when they left. The agitation was highest when the patients first entered the recovery room and lowest when they were leaving.
There was a noticeable difference in agitation levels between patients who had surgery for a cleft lip, cleft palate, or a type of cleft called “horizontal cleft.” The patients with cleft lips were less agitated while in the recovery room compared to the patients with cleft palates or horizontal clefts. However, there was no significant difference in agitation levels among these groups when they first entered or left the recovery room.
In conclusion, kids tend to be quite agitated after surgery for a cleft lip, palate, or horizontal cleft, especially when they first arrive in the recovery room. Kids who have undergone surgery for a cleft palate or a horizontal cleft seem to experience higher levels of agitation while in the recovery room compared to those who had cleft lip surgery.
FAQs
- What is “emergence agitation” (EA) and how is it related to cleft palate surgery?
- According to the research, at what points during the recovery process were children most agitated after cleft palate surgery?
- Are there differences in agitation levels between kids who have undergone surgery for a cleft lip, cleft palate, or horizontal cleft?
Doctor’s Tip
A helpful tip a doctor might give to a patient about cleft palate surgery is to be prepared for the possibility of post-operative agitation, especially in the immediate recovery period. It’s important to stay calm and reassure your child during this time, as agitation is a common side effect of anesthesia and surgery in children with cleft lip or palate. Additionally, make sure to follow any post-operative care instructions provided by your healthcare team to ensure a smooth recovery process.
Suitable For
Overall, patients who have had cleft palate surgery are typically recommended cleft palate surgery to correct the physical deformity and improve their ability to eat, speak, and breathe properly. Additionally, cleft palate surgery can also improve the overall appearance of the patient’s face and boost their self-confidence.
It’s important to note that each patient is unique and may have different needs and considerations when it comes to cleft palate surgery. Therefore, it’s crucial for patients to consult with a team of healthcare professionals, including surgeons, speech therapists, and psychologists, to determine the best course of action for their individual situation.
Timeline
Overall, the timeline of a patient’s experience before and after cleft palate surgery can be summarized as follows:
Pre-operative preparation: The patient and their family will meet with the surgical team to discuss the procedure, risks, and expectations. The patient may undergo pre-operative testing and evaluations to ensure they are healthy enough for surgery.
Day of surgery: The patient will be admitted to the hospital or surgical center and prepared for surgery. They will receive general anesthesia before the surgery begins.
During surgery: The surgical team will perform the cleft palate repair, which typically takes a few hours. The patient will be closely monitored throughout the procedure.
Post-operative recovery: After the surgery is complete, the patient will be taken to the recovery room (PACU) to wake up from anesthesia. This is when emergence agitation may occur, leading to restlessness or confusion.
Discharge: Once the patient is fully awake and stable, they will be discharged from the hospital or surgical center. The surgical team will provide instructions for post-operative care and follow-up appointments.
Follow-up care: The patient will have regular follow-up appointments with the surgical team to monitor their healing progress and address any concerns or complications.
Overall, the timeline of a patient’s experience before and after cleft palate surgery involves thorough preparation, the surgical procedure itself, post-operative recovery, and ongoing follow-up care to ensure the best possible outcome.
What to Ask Your Doctor
Some questions a patient should ask their doctor about cleft palate surgery include:
- What are the potential risks and complications associated with cleft palate surgery?
- How long is the recovery process and what can I expect during this time?
- Will my child experience emergence agitation after surgery, and if so, how will it be managed?
- How can I best prepare my child for cleft palate surgery and the recovery period?
- What follow-up care will be needed after the surgery?
- Are there any specific dietary restrictions or special considerations that need to be taken into account post-surgery?
- What type of pain management will be used during and after the surgery?
- Will my child need speech therapy or other interventions following cleft palate surgery?
- How long until my child can resume normal activities and return to school after surgery?
- What are the long-term outcomes and potential future surgeries or treatments that may be needed for a child with a cleft palate?
Reference
Authors: Shi Y, Zhang X, Sun Y, Mei E, Wan X, Tian L. Journal: J Stomatol Oral Maxillofac Surg. 2021 Dec;122(6):539-543. doi: 10.1016/j.jormas.2020.11.006. Epub 2020 Dec 7. PMID: 33301949