A bite of death: Anaesthetic challenges in frostbite

Background: Frostbite is defined as tissue damage that is sustained as a result of prolonged exposures to less than 0°C resulting in ice crystallisation, microvascular occlusion and subsequently thrombosis. Case: A 33-year-old mountaineer with cold burn over 20% of the total body surface area with eschar formation, acute renal failure, upper limb venous thrombosis and bilateral pleural effusion. We hereby report a successful anaesthetic management of this patient undergoing debridement and escharotomy for frostbite injuries and review its perioperative concerns. Conclusion: Frostbite injuries pose a challenge to the anaesthetic team due to the multi-systemic nature of its involvement.