Patients undergoing BRP standing alone or as part of a multilevel approach for the treatment of OSAHS have a reasonable expectation for success with minimal morbidity.

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Editor,Sevoflurane is a popular inhalational agent which has been used for induction and maintenance of anaesthesia for 25 years; it is largely assumed to be safe for induction of anaesthesia in children, often being administered before establishing an intravenous line. There are no documented cases of inhalational agents causing anaphylaxis in the perioperative setting. 1 We found only three case reports of sevoflurane allergy in the literature: two cases refer to occupational asthma in anaesthetic staff in the same hospital 2 and the other case refers to allergic dermatitis in a surgeon after long-term exposure to sevoflurane. 3 We describe a case of cutaneous reaction due to sevoflurane administration in a paediatric patient undergoing general anaesthesia.A healthy 12-year-old male, 48 kg and 154 cm tall, was admitted for urgent nasal fracture reduction. His mother reported a previous cutaneous reaction at the age of 5 months, 30 min after being submitted to a head computed tomography scan under sedation (without contrast), in another hospital; medical records of that event are unavailable and we have no knowledge of which drugs were administered there at the time. He had no other known allergies.The patient did not receive premedication. After starting fluid therapy with Hartmann ' s solution, intravenous induction was achieved with fentanyl 2 mg kg À1 , propofol 2.5 mg kg À1 and rocuronium 0.4 mg kg À1 ; dexamethasone 80 mg kg À1 was also administered and the airway was secured with a cuffed orotracheal tube. Maintenance was planned with sevoflurane in oxygen and air, but 1 min after initiating sevoflurane 1%, the patient developed an exuberant skin rash mainly in the neck and thorax, so the gas was immediately discontinued and there was rapid regression of the rash. Surgery continued uneventfully under propofol boluses. Other drugs were administered as shown in Fig.

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INTRODUÇÃO: As laringectomias subtotais reconstrutivas supracricoideias com cricohioidoepiglotopexia e cricohioidopexia foram introduzidas para tratar radicalmente os tumores da laringe em doentes selecionados, respeitando as funções deste órgão (deglutição, fonação e respiração). A dispneia, é uma possível complicação a curtoprazo destes procedimentos, que é evitada com traqueotomia temporária. As estenoses laríngeas pós-laringectomia subtotais reconstrutivas são pouco comuns e atrasam o processo de descanulação. Apresenta-se o caso clínico de um doente submetido a cricohioidoepiglotopexia com uma complicação pós-operatória rara caracterizada por uma epiglote muito descida e com báscula posterior, causando estenose laríngea e atraso da descanulação. Esta complicação foi resolvida com sucesso por microcirurgia laríngea com laser CO2. Recebido: 11/09/2016 - Aceite: 17/10/2016