LAUSR

We report the airway management in a 4-year-old patient presenting for reconstruction surgery of the face. [Figure 1] Patient had developed complete loss of mouth opening following necrotising infection of the face. Facial reconstruction using a deltopectoral flap was planned under general anaesthesia. Premedication drugs included intravenous glycopyrrolate 0.1mg kg-1; midazolam 100mcg kg-1; 4% atomised lignocaine; intranasal xylometazoline drops, 15 minutes before induction of anaesthesia. Induction of anaesthesia was done with intravenous ketamine 1mg kg-1; fentanyl 2mcgkg-1(in small aliquots); sevoflurane in gradual increments. Spontaneous ventilation and bag-mask ventilation were ensured. After induction, 2ml of 4% lignocaine was injected intratracheally to facilitate fiberoptic bronchoscope (FOB) assisted intubation.