Background Musculocontractural Ehlers-Danlos syndrome is a new and rare subtype of Ehlers-Danlos syndrome in which anesthetic considerations for airway and respiratory management, prevention of skin injuries and joint dislocations, and hemostatic management for severe perioperative bleeding are required. Case presentation A 19-year-old woman with musculocontractural Ehlers-Danlos syndrome was scheduled to undergo posterior spinal fusion from the 4th thoracic to the 4th lumbar vertebrae under general anesthesia. Her trachea was easily intubated with a videolaryngoscope despite a small mouth and micrognathia. Pressure-controlled ventilation with limited peak inspiratory pressure was performed for prevention of pneumothorax. Skin damage and joint luxation were prevented by using a low rebounding mattress, terpolymer-based barrier film, and careful patient positioning. Blood transfusion was effectively performed on the basis of point-of-care viscoelastic hemostatic assay monitoring. She had an uneventful postoperative course without any complications. Conclusions We safely managed a patient with musculocontractural Ehlers-Danlos syndrome undergoing scoliosis surgery.

Background Anaphylaxis caused by a catheter itself used for endovascular surgery is rare, and a method for detection of a causative catheter has not been established. We report a case of catheter-induced anaphylaxis in which the causative catheter was successfully detected. Case presentation A 47-year-old male underwent neuroendovascular surgery. During surgery, blood pressure suddenly dropped and the level of tryptase indicated the occurrence of anaphylaxis. There were 24 candidate agents for the cause of anaphylaxis including 8 catheters. We performed the basophil activation test by directly mixing the catheter with blood. One catheter coated with a hyaluronic acid product showed a positive reaction, and we confirmed the result by a modified skin test using an elution solution of the catheter. Later, we successfully completed the neuroendovascular surgery without the catheter. Conclusions The methods used in this case can be useful for the detection of the causative agent in catheter-induced anaphylaxis.

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Direct laryngoscopy under NLA without intratracheal intubation is useful for observing the vocal cord movements during patients' phonation, for easy insertion of the scope and for excellent visualization of the larynx.However, prolonged surgery is not feasible owing to occasional suppression of breathing by NLA. We deviced a new technique of Non-intubation Oxygen jet method .A small tube was attached to the conventional scope. Once a patient was sedated, muscle relaxant was administered. Oxygen jet was injected into the trachea via the above mentioned tube, which was connected to Oxygen source, by controlling a flush valve of a anesthesia machine.Arterial Po, and Pco2 levels were satisfactory during laryngomicrosurgery.