Anaesthesia Challenges in Patients with Bear Bite

Abstract

Background and Aims: Patients injured in bear attack present with different patterns of injuries. A common protocol may not be suitable for the management of injuries inflicted by these large wild animals. Anaesthetic management of such injuries often need multidisciplinary approach. Here, we reported case series of anaesthesia challenges in Bear bite patients who were brought to Govt. Medical College and Hospital, Nagpur; and were managed in emergency situations for surgery under anaesthesia. Method: This retrospective observational study was conducted on total 10 cases of either sex, having age ranging from 30-50 years, over a period of two years. The data was collected from case records and analyzed accordingly. Results: Due to injury over face and oedema, there was problem of ventilation with Ambu Bag as far as casualty management was concerned. It was difficult to hold the anaesthesia circuit mask while preoxygenation before induction and intubation. Also we faced difficulty in laryngoscopy and Intubation due to distorted anatomy of face and oedema. In few cases, Bear bite injury was noted on limb, chest and abdomen. Some of patients were required multiple surgical intervention/ operated to cover the wound gap and disfigurement leading to multiple exposure to general anaesthesia. Only one patient was required to be intubated and mechanically ventilated before taken for definitive surgical repair. Conclusion: In our case series, there was no mortality. The main challenges to anaesthesiologist were Emergency Airway Management, Blood and Fluid Resuscitation either at casualty or in the operation theatre.