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Novel Position for Laryngeal Mask Airway Insertion in Patients with Postburn Contracture over Neck: A Case Series
Prashant Shivaraj Sajjan1, Vandana Sharashchandra Kulkarni1
1Department of Anesthesiology, Aarupadai Veedu Medical College, Puducherry, India.
Abstract:
Difficult intubation in cases of post burn contracture over neck is a known problem. We report five cases of postburn contracture over neck, posted for scar excision and split skin grafting. Detailed preanesthetic examination and airway evaluation was done. Anticipating difficulty in conventional laryngoscopy and endotracheal intubation in these patients due restricted neck movements we planned to manage these cases under general anesthesia using classic laryngeal mask airway (LMA). Standard method of LMA insertion was unsuccessful. The patients were repositioned using shoulder elevation and jaw thrust after which LMA could be successfully inserted in these patients. The cases were subsequently managed uneventfully. Classic LMA can be used as a useful alternative in the management of difficult airway for the administration of general anesthesia. In cases where standard method is unsuccessful elevation of shoulders can help in insertion of LMA.
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