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Published in: Journal of Anesthesia 1/2012

01-02-2012 | Clinical Report

Severe post-burn neck contracture release and skin graft harvest using tumescent local anaesthesia as the sole anesthetic technique

Authors: Mukesh Kumar Prasad, Pulak Puneet, Kanchan Rani, Divya Shree

Published in: Journal of Anesthesia | Issue 1/2012

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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.
Literature
1.
go back to reference Klein JA. The tumescent technique for liposuction surgery. Amer J Cosm Surg. 1987;4:263–7. Klein JA. The tumescent technique for liposuction surgery. Amer J Cosm Surg. 1987;4:263–7.
2.
go back to reference Ninan S, Gupta AK, Ramkumar G. A technique in positioning the neck during mentosternal contracture release. Burns. 2003;29:613–4.CrossRefPubMed Ninan S, Gupta AK, Ramkumar G. A technique in positioning the neck during mentosternal contracture release. Burns. 2003;29:613–4.CrossRefPubMed
3.
go back to reference Nath S, Erzingatsian K, Simond S. Management of post burn contracture of the neck. Burns. 1994;20:438–41.CrossRefPubMed Nath S, Erzingatsian K, Simond S. Management of post burn contracture of the neck. Burns. 1994;20:438–41.CrossRefPubMed
4.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
5.
go back to reference 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.CrossRef 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.CrossRef
6.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
7.
go back to reference American Society of Dermatologic Surgery. Guiding principles for liposuction. Dermatol Surg. 1997;23:1127–9.CrossRef American Society of Dermatologic Surgery. Guiding principles for liposuction. Dermatol Surg. 1997;23:1127–9.CrossRef
8.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
9.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
10.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
11.
go back to reference 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. 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.
12.
go back to reference Craig SB, Concannon MJ, McDonald GA, Puckett CL. The antibacterial effects of tumescent liposuction fluid. Plast Reconstr Surg. 1999;103:666–70.CrossRefPubMed Craig SB, Concannon MJ, McDonald GA, Puckett CL. The antibacterial effects of tumescent liposuction fluid. Plast Reconstr Surg. 1999;103:666–70.CrossRefPubMed
13.
go back to reference Clark LE, Mellette JR. The use of hyaluronidase as an adjunct to surgical procedures. J Dermatol Surg Oncol. 1994;20:842–4.CrossRefPubMed Clark LE, Mellette JR. The use of hyaluronidase as an adjunct to surgical procedures. J Dermatol Surg Oncol. 1994;20:842–4.CrossRefPubMed
Metadata
Title
Severe post-burn neck contracture release and skin graft harvest using tumescent local anaesthesia as the sole anesthetic technique
Authors
Mukesh Kumar Prasad
Pulak Puneet
Kanchan Rani
Divya Shree
Publication date
01-02-2012
Publisher
Springer Japan
Published in
Journal of Anesthesia / Issue 1/2012
Print ISSN: 0913-8668
Electronic ISSN: 1438-8359
DOI
https://doi.org/10.1007/s00540-011-1246-9

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