The peri-operative management of post-burn contractures of the neck is a challenge not only to the surgeon but also the anaesthesiologist. A proper coordination between them is needed for providing a hassle-free patient care. This is a prospective study done on 30 consecutive patients of post burn contractures of the neck to compare the surgeon's assessment of the type and pattern of post-burn contracture of the neck and the anaesthesiologist's assessment of the airway. The association of this with the peri-operative management of patients was also studied. The data analysed was type of contracture, mento-sternal distance, and preoperative grading of the airway. The method of securing intra-operative airway was documented. A direct co-relation was noted between the type of contracture with the Mallampatti grading of the airway and the sterno-mental distance. All type III contractures required release before intubation. In conclusion, it is advisable for the surgeon to be well-versed with the anaesthesiologist's assessment of the airway and the anaesthesiologist to aware of the types of neck contracture in order to properly plan and execute the peri-operative management of these patients.

BACKGROUND: Brachial plexus nerve blocks (BPB) are the most common nerve blocks used for upper limb surgeries. Techniques using only Local Anaesthetics (LA) have limited duration of post-operative analgesia. Clonidine has been used to prolong the duration of LA s for neuraxial blocks. Hence the effect of clonidine on Lidocaine induced BPB was studied. METHODS: 60 patients of American Society of Anesthesiologists (ASA) class I and II were randomly divided into 2 groups. Group L given 30 ml of Lidocaine with adrenaline 1.5% with 0.6 ml of normal saline and the Group C given 30 ml of same LA with 0.6 ml of 90mcg of Clonidine. All the patients' supraclavicular BPB was given using Winnies' peri-vascular approach. The primary outcome was onset, duration of sensory and motor blockade. The secondary outcomes were motor block duration, opioid supplementation, and BPB complication. RESULTS: There was no statistically significant difference in the onset of sensory and motor block, motor blockade quality and overall quality of block. Duration of sensory and motor blockade was prolonged in groups with Clonidine. No adverse events / hemodynamic instability noted in either group. Sedation scores were higher in Clonidine group. No patients required any intervention. CONCLUSIONS: 90µg Clonidine added to Lidocaine 1.5% with adrenaline produces prolongation of both the duration of sensory and motor blockade with minimal adverse effects.