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CASE REPORT
Year : 2016  |  Volume : 2  |  Issue : 1  |  Page : 33-35

Anaesthetic Management of Difficult Airway and Intravenous Access due to Post Burn Contracture


Department of Anaesthesia, Indira Gandhi Institute of Medical Sciences, Sheikhpura, Patna, Bihar, India

Correspondence Address:
Rajnish Kumar
Assistant Professor Dept. of Anesthesia IGIMS, Patna-14
India
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Source of Support: None, Conflict of Interest: None


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We describe anaesthetic management of 41-year-old female admitted for total abdominal hysterectomy having history of 35% full thickness burn with scar marks over face, neck, both upper limbs whole of anterior abdomen and inguinal region on both sides. Graft was taken from both thigh and right leg which had left scar mark. With burn contractures over neck and involvement of limbs she was difficult to intubate and difficult intravenous access as well. Keeping in view the difficult airway access she was planned for combined spinal epidural anaesthesia. Gaining intravenous access posed a challenge because of burns scars on upper limbs, graft scars on both thigh and right leg. Central venous cannulation was not attempted because of distorted anatomy of neck. Left leg was warmed by wrapping it in towels moistened with warm water to dilate veins and intravenous line secured. Because of pain experienced by patient after an hour of starting surgery general anaesthesia was given and airway secured with i- Gel, which went uneventful.


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