Successful Anaesthetic Management of a Patient with Post Burn Contracture and Difficult Airway: A Case Report
Journal Title: International Journal of Contemporary Medical Research - Year 2017, Vol 4, Issue 2
Abstract
Introduction: A post burn patient with contracture involving the orofascial tissues was posted for contracture release and skin grafting. Due to extensive scarring of orofascial tissues, the mouth opening was very less and orifices of nostrils were distorted. Limited mouth opening lead to reduced intake of food by the patient, hence was malnourished and emaciated. Case report: This patient posed two problems to us viz. difficult airway due to limited mouth opening resulting from orofascial scarring; relaxant dose adjustment because of malnourishment and emaciation. In the anaesthetic management, surgeon was requested to incise the scar tissue at the angle of mouth on both sides after infiltration of local anaesthetics. Once mouth opening widened, routine general anaesthesia with intubation was administered. Patient was managed with single dose of suxamethonium and did not require long acting relaxant. The course and recovery from anaesthesia were largely uneventful. Conclusion: Management of difficult airway becomes easier with adequate planning and when due precautions are taken. In malnourished and emaciated individuals, judicious use of muscle relaxants is advisable.
Authors and Affiliations
J. V. Subba Rao, Md Sirajuddin, J Rajesh
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