Abstract
Severe post-burn contractures in the neck often cause anatomical distortion and restriction of neck movements, resulting in varying degrees of difficulty in airway management. Any mode of anesthesia that may obviate the need for imperative airway control may be desirable in such situations in which a difficult airway may be anticipated. Here we present one such situation where tumescent local anesthesia was employed to manage a case of severe post-burn neck contractures posted for contracture release and split-skin grafting. The other benefits of this method were minimal blood loss and excellent postoperative analgesia. In conclusion, it can be emphasized that the application of tumescent anesthesia is an important anesthetic tool in patients with predicted difficult airway management.
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References
Klein JA. The tumescent technique for liposuction surgery. Amer J Cosm Surg. 1987;4:263–7.
Ninan S, Gupta AK, Ramkumar G. A technique in positioning the neck during mentosternal contracture release. Burns. 2003;29:613–4.
Nath S, Erzingatsian K, Simond S. Management of post burn contracture of the neck. Burns. 1994;20:438–41.
Kumar R, Prashast, Wadhwa A, Akhtar S. The upside down intubating laryngeal mask airway: a technique of cases of fixed flexed neck deformity. Anesth Analg. 2002;95:1454–8.
Sommer B. Advantages and disadvantages of tumescent local anesthesia. In: Hanke CW, Sommer B, Sattler G, editors. Tumescent local anesthesia. New York: Springer; 2001. p. 47–51.
Klein JA. Tumescent technique for regional anesthesia permits lidocaine doses of 35 mg/kg for liposuction surgery. J Dermatol Surg Oncol. 1990;16:248–63.
American Society of Dermatologic Surgery. Guiding principles for liposuction. Dermatol Surg. 1997;23:1127–9.
Ramon Y, Barak Y, Ullmann Y, Hoffer E, Yarhi D, Bentur Y. Pharmacokinetics of high dose diluted lidocaine in local anesthesia for facelift procedures. Ther Drug Monit. 2007;29:644–7.
Raymond SA, Steffensen SC, Gugino LD, Strichartz GR. The role of length of nerve exposed to local anesthetics in impulse blocking action. Anesth Analg. 1989;68:563–70.
Bussolin L, Busoni P, Giorgi L, Crescioli M, Messeri A. Tumescent local anesthesia for the surgical treatment of burns and postburn sequelae in pediatric patients. Anesthesiology. 2003;99:1371–5.
McKay W, Morris R, Mushlin P. Sodium bicarbonate attenuates pain on skin infiltration with lidocaine with or without epinephrine. Anesth Analg. 1989;66:572–4.
Craig SB, Concannon MJ, McDonald GA, Puckett CL. The antibacterial effects of tumescent liposuction fluid. Plast Reconstr Surg. 1999;103:666–70.
Clark LE, Mellette JR. The use of hyaluronidase as an adjunct to surgical procedures. J Dermatol Surg Oncol. 1994;20:842–4.
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Prasad, M.K., Puneet, P., Rani, K. et al. Severe post-burn neck contracture release and skin graft harvest using tumescent local anaesthesia as the sole anesthetic technique. J Anesth 26, 97–99 (2012). https://doi.org/10.1007/s00540-011-1246-9
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DOI: https://doi.org/10.1007/s00540-011-1246-9