This study will propose and evaluate a standardized LeFort osteotomy anesthetic protocol for pediatric patients at Johns Hopkins Hospital. There are two cohorts to this study: a prospective cohort who will receive the study anesthesia protocol and a historical cohort that received standard of care. The investigators hope this will help to minimize unnecessary postoperative pain management, inpatient stay, and long-term morbidity and mortality in these patients.

This study will propose and evaluate a standardized LeFort osteotomy anesthetic protocol for pediatric patients at Johns Hopkins Hospital. There are two cohorts to this study: a prospective cohort who will receive the study anesthesia protocol and a historical cohort that received standard of care. The investigators hypothesize that implementation of this standardized protocol will show improved surgical outcomes among these patients as compared to current (discretionary) treatment. This study aims to optimize the anesthetic management of these patients in order to minimize postoperative pain management, inpatient stay, and long-term morbidity and mortality in these complex patients.

Inclusion Criteria:

• Undergoing Le Fort osteotomy at Johns Hopkins Hospital
• Age >= 14 years

Exclusion Criteria:

• Contraindications to standardized anesthetic protocol (intervention arm)

IPD will be shared with those conducting research data collection and analysis, and IPD that underlie results in a publication will be published.

Data will become available to the study team upon collection and will be deleted after publication

IPD access will be granted to those researchers making significant contributions to data collection or analysis, at the discretion of the principal investigator