PURPOSE We present the anesthetic management of a parturient with VACTERL association undergoing combined regional and general anesthesia for Cesarean delivery. Defined as a syndrome, VACTERL association comprises at least three of the following abnormalities: vertebral, anal atresia, cardiac, tracheoesophageal, renal, and limb. CLINICAL FEATURES The patient's anatomic abnormalities and comor...

Airway management of patients with very limited mouth opening remains a challenge for the anaesthetist. We describe the use of the Bonfils Intubation Fiberscope for awake intubation in two patients with a very limited mouth opening. In the first case, a 60-year-old 80 kg female, scheduled for a right modified radical mastectomy for infiltrating ductal carcinoma (15 mm mouth opening, a short thi...

A 63-year-old woman was referred to the sleep center complaining of daytime sleepiness, snoring, and insomnia. She was single and never married but, on a recent business trip, was noted by a colleague to snore loudly. There was no report of witnessed apnea. She slept 8 to 8.5 hours per night but complained of daytime drowsiness and mental fogginess, particularly in the afternoons. She occasiona...

Mallampati et al, proposed a grading system to anticipate difficult intubation, which considers visualization of faucial pillars, soft palate and base of uvula. 4 The upper lip bite test (ULBT) was proposed as a simple bed side technique by Khan et al, which involves the assessment of jaw subluxation and presence of buck teeth. 9 Savva et al, proposed sternomental distance (distance from the su...

Apert syndrome is a type of acrocephalosyndactilia that consists of craniofacial synostosis, midface hypoplasia and syndactyly, with an autosomal dominant inheritance pattern. During anesthesia, difficult intubation and ventilation may be observed because of abnormal airways. In one of our patients, visceral anomalies, such as esophageal stricture and post-strictural dilatation, may cause respi...

We describe the Elisha Airway Device (EAD), a new reusable supraglottic ventilatory device. Its uniqueness consists of its ability to combine three functions in a single device: ventilation, blind and/or fiberoptic-aided intubation without interruption of ventilation, and gastric tube insertion. This study was performed in 70 ASA status I-II, Mallampati class I-II patients undergoing elective k...