Crocodile attack
injuries plague communities near bodies of water and continue to be an infrequent but significant form of
trauma encountered in our medical facility.
Regional anesthesia techniques are a novel adjunct to treatment and may facilitate simplified definitive management and better utilization of constrained operating room resources. We report a case of an adult male who presented with a large lower extremity
wound after a crocodile
bite. The patient was managed with initial
debridement and irrigation and serial
wound care entirely under
regional anesthesia at the bedside. The patient did not develop
wound infection, eventually receiving a skin graft with good functional outcomes.
Regional anesthesia techniques are increasingly being used in the
trauma setting, and their versatility allows for their use in multiple settings, by practitioners with limited experience and in resource-limited environments. No specific guidelines exist for performance of neuraxial techniques in the setting of animal
bite injuries, but concerns about infectious complications have been raised.
Regional anesthesia techniques may be useful in the management of extremity
trauma due to crocodile attacks without infectious complications. They may reduce utilization of theatre resources and reduce
opioid requirements.