Tuesday in Labo

Our first infant (4 month) cleft lip of the mission.

If baby #2 (four weeks)  had severe feeding difficulty it would have been  more urgent to address her cleft lip.

#2 looks good the afternoon of surgery, after all the excitement in PACU.

I slept better last night. I didn't hear my roommate, Ron, get out of bed but I woke up when he opened the bathroom door. I was on the first van to the hospital so I had plenty of time to set up. First case was a four month, four kg child for a cleft palate repair. Apart from difficulty placing an IV the case went well. I gave the child infra-orbital nerve blocks, going in through the buccal mucosa, and the baby was very comfortable in PACU. The second case demonstrated why its not a good idea to operate on children less than fifty weeks post-conception. Bilateral lip, four kg., same technique but this child (27 days old) had about ten minutes of apneic episodes after fifteen minutes in PACU. I bagged her a couple of times and gave her jaw-thrust airway support. The third case was a two year- old for a lip.   #4 a fibroma on the left side of a two year-old's nose. #5 a two year-old with a cyst in front of her left ear. The infra-orbital blocks worked well. Tess Sabado , the anesthesiologist who is president of the local rotary, was interested in the caudal that I gave #6, a ten year-old with a right inguinal hernia. #7 was a very slender 33 year-old with a right hydrocele. He got a spinal. Some very nice spinal trays turned up and I was happy to have them. Tomorrow promises to be busy, but no pediatric cases.

This young lady was not too excited about meeting me, even after I gave her  five pesos.