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Anaesthesia for a "Scalped" Patient
M M Rizvi1, Raj Bahadur Singh1, Arindam Sarkar1
1Assistant Professor, Department of Anaesthesiology and Critical Care, Era's Lucknow Medical College and Hospital , Lucknow, India .
Journal of Clinical and Diagnostic Research : JCDR
|August 13, 2015
Summary
This case report details the successful management of a rare trichilemmal carcinoma of the scalp. The study highlights anesthetic techniques for complex scalp tumor surgery in a challenging lateral position.
Area of Science:
- Oncology
- Anesthesiology
- Surgical Oncology
Background:
- Trichilemmal carcinoma of the scalp is a rare malignant neoplasm.
- Surgical management presents challenges, especially with extensive lesions involving the skull.
Observation:
- A 52-year-old female presented with an extensive, ulcerative occipital scalp lesion with associated bony skull loss.
- The patient required intubation and central venous catheter (CVC) placement in the left lateral decubitus position, a technically demanding scenario.
Findings:
- Anesthesia was successfully maintained, and the CVC was placed using ultrasonography (USG) guidance in the right internal jugular vein.
- The patient underwent surgical management and extubation while maintained in the lateral position, with an uneventful postoperative course.
Implications:
- This case underscores the importance of specialized anesthetic techniques for managing complex scalp malignancies.
- Successful surgical resection and anesthetic management in challenging positions can lead to favorable patient outcomes.