Anaesthetic management of maxillofacial surgeries: A cross-sectional survey to analyze current trend of practices

Abstract

Anaesthetic management of maxillo-facial surgeries considered as special subset of surgery where the airway management needs proper attention. Most of the time it varies depending on the resources and skill availability. We tried to evaluate the current trend of practices in managing maxilla-facial surgeries among various practicing anaesthesiologists. This is a retrospective questionnaire based survey conducted among practicing anaesthesiologists to determine the trend of practices and institutional protocols followed for maxillo-facial surgeries. A set of questionnaires prepared to ask about the preferred mode of securing airway, frequency of facing complications and plan for extubation and post-operative management. Total of 86 responses were collected which were analyzed. A total of 91% evaluated the airway with history and physical examination. Fiberoptic broncoscope available in 46% of cases, 51% cases video laryngoscope was preferred as gadget. Naso-tracheal is the commonest route for securing the airway which was preferred by 53% respondents. Only 38% respondents were in favor of extubation of the patients inside the operation theatres after surgery for patients without head injury. In patients with head injury 90% responders believed either a delayed extubation in the ICU or elective ventilation for some hours before extubation is a better option. Most of the anaesthesiologists (61%) preferred shifting the patients to the ICU for post-operative care. Theanaestheticmanagement ofmaxillo-facial surgeries need special attention. It necessitates proper pre-operative evaluation, shared decision making with the surgeons, timely decision of extubation and post-operative care are keys to successfully manage the airway.