A technique in positioning the neck during mentosternal contracture release

Ninan, Shiby; Gupta, Ashish Kumar; Ramkumar, G

doi:10.1016/s0305-4179(03)00150-5

Cited by 4 publications

(3 citation statements)

References 1 publication

Supporting

Mentioning

Contrasting

Order By: Relevance

“…(Figure 1) This difficulty in managing airway can result in serious complications and sequelae. 1,2 Tumescent local anesthesia (TLA) is a technique to achieve extensive regional anesthesia of the skin and subcutaneous tissue by direct infiltration of large volumes of dilute local Anesthetic solution into subcutaneous plane. Dr. Jeffrey Klein in 1987 first described the technique of tumescent local anesthesia when he used large volumes of a diluted solution of lignocaine with adrenaline for infiltration into fat before liposuction.…”

Section: Introductionmentioning

confidence: 99%

Tumescent local anesthesia as an alternative to general anesthesia in release of post-burn neck contracture and skin graft harvesting: A comparative study

Prasad

Jain

Varshney

et al. 2021

APIC

View full text Add to dashboard Cite

Background: Anesthetic management of severe post burn neck contracture is difficult, demanding due to fixed flexion deformity of neck, incomplete oral occlusion and insufficient mouth opening leading to difficulty in intubation. Patients undergoing contracture release, skin graft harvest under general anesthesia (GA) were compared with patients undergoing the same surgery under tumescent local anesthesia (TLA) technique. Methodology: Twenty-one patients with post burn neck contracture undergoing contracture release with split skin grafting under GA were compared with twenty-one patients undergoing the same surgery under TLA. Post-operative pain and satisfaction were assessed using 10 cm VAS (Visual Analogue Scale). Results: Demographic profile was comparable in both groups. Changes in intra-operative vital parameters remained insignificant. The average volume of tumescent solution used was 254.76 + 49.05ml. Blood loss was significantly decreased, postoperative pain relief was more than sixteen hours in thirteen patients and extended beyond twenty-four hours in six patients in the TLA group. Time for the first rescue analgesia was significantly lesser in the GA group and the average dose of injection tramadol used in the GA group was significantly higher within the first 24 h. Overall satisfaction in the TLA group was significantly higher than in the GA group. Conclusion: TLA can be used as sole technique for release of post burn neck contracture and harvest of split skin grafts with less blood loss and significantly better postoperative pain relief avoiding complications of general anesthesia. Key words: Tumescent local anesthesia; Post burn neck contracture; Skin graft harvest; General anesthesia Citation: Prasad MK, Jain P, Varshney RK, Khare A, Jheetay GS. Tumescent local anesthesia as an alternative to general anesthesia in the release of post-burn neck contracture and skin graft harvesting: A comparative study. Anaesth. Pain intensive care 2021;25(1):34–39. DOI: 10.35975/apic.v25i1.1434 Received: 18 February 2020, Reviewed: 16 March 2020, Accepted: 30 April 2020

show abstract

Section: Introductionmentioning

confidence: 99%

Tumescent local anesthesia as an alternative to general anesthesia in release of post-burn neck contracture and skin graft harvesting: A comparative study

Prasad

Jain

Varshney

et al. 2021

APIC

View full text Add to dashboard Cite

show abstract

“…Severe post-burn neck contracture often causes insufficient neck extension, incomplete oral occlusion, and insufficient mouth opening [2,3]. All these restrictions of movement compromise access to the airway.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2011

View full text Add to dashboard Cite

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.

show abstract

“…This results in difficult intubation that can be life threatening and can result in multiple serious complications and sequels. 1,2 To circumvent these complications contracture is released initially under local anesthesia to allow sufficient neck extension and then the anesthesiologist intubates the patient. Then the surgery is continued under general anaesthesia.…”

Section: Introductionmentioning

confidence: 99%

Safe method for release of severe post burn neck contracture under tumescent local anaesthesia and ketamine

Agarwal

2004

Indian J Plast Surg

View full text Add to dashboard Cite

Severe post burn neck contracture results in difficult intubation, which can be life threatening and can result in multiple serious complications and sequels. Thirty patients with age ranging from 12 to 50 years were operated under local tumescent anesthesia supplemented with intravenous ketamine for release of post burn neck contracture and split skin grafted. This technique obviates the need for endotracheal intubation. There were no complications attributed to this anesthesia technique. There was no graft loss and blood loss was minimal.

show abstract

A technique in positioning the neck during mentosternal contracture release

Cited by 4 publications

References 1 publication

Tumescent local anesthesia as an alternative to general anesthesia in release of post-burn neck contracture and skin graft harvesting: A comparative study

Tumescent local anesthesia as an alternative to general anesthesia in release of post-burn neck contracture and skin graft harvesting: A comparative study

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

Safe method for release of severe post burn neck contracture under tumescent local anaesthesia and ketamine

Contact Info

Product

Resources

About