Cleft lip and palate with diabetes insipidus: Perioperative management

Nasal desmopressin spray is used for the management of diabetes insipidus (DI). Difficulties arise during the perioperative period of cleft repair for the management of DI with nasal desmopressin due to decreased nasal absorption and reduced oral intake. Key to successful peri-operative management is strict monitoring of serum electrolytes, serum and urine osmolality, and fluid administration titrating to urine output. Oral and intravenous desmopressin needs to be used in the perioperative period for managing the condition.