MSC FRCPCPurpose: To present a case of respiratory arrest following the use of intrathecal sufentanil and bupivacaine for combined spinal-epidural anaesthesia in a healthy labouring parturient, Clinical Features: A 20-yr-old term parturient received I 0 pg sufentanil and 2,5 mg bupivacaine intrathecally as part of a combined spinal-epidural technique for labour analgesia. She had received no previous analgesics. Twenty-three minutes after the intrathecal injection she became unresponsive and suffered a respiratory arrest. Resuscitation included manual bag/mask ventilation with oxygen and intravenous naloxone. Conclusion: Respiratory arrest is a rare but potentially life-threatening complication associated with the use of intrathecal opioids for labour analgesia. Vigilance in post-procedure patient monitoring is imperative.

Purpose: To describe the anesthetic considerations for a nearterm parturient with progressive cauda equina syndrome who required Cesarean delivery followed immediately by decompression lumbar discectomy and laminectomy in the prone position. Clinical features:A 33-yr-old woman presented at 35 weeks gestation with severe L5-S1 disc herniation causing motor and sensory neuronal dysfunction in the lower limbs accompanied by bowel and bladder dysfunction. After urgent multidisciplinary consultations, a decision was made to proceed with general anesthesia for Cesarean delivery in the supine position with left uterine displacement, followed immediately thereafter by L5-S1 discectomy and laminectomy in the prone position. Anesthesia concerns included the risks of hemorrhage from the combined surgeries and upper airway edema from the prone position, and the physiologic changes of pregnancy. The surgeries proceeded without complication, and both mother and baby recovered uneventfully. Conclusion:With a multidisciplinary approach, two surgeries in two different positions with unique anesthetic considerations were performed safely under general anesthesia in advanced pregnancy in a parturient with cauda equina syndrome. F EW cases of cauda equina syndrome during pregnancy have been reported in the literature. [1][2][3][4][5] Most of these cases involved cauda equina syndrome in parturients early in pregnancy (before 24 weeks of gestation.). Recently, Brown and Brookfield reported performing a Cesarean delivery and laminectomy in a parturient who was eight months pregnant. 5 Our case report is the first to discuss the anesthetic management of a parturient at 35 weeks gestation who underwent a Cesarean delivery followed by laminectomy in the prone position under the same general anesthetic for cauda equina syndrome. The patient gave written consent for publication of this information. CASE REPORTS/CASE SERIES 471CAN J ANESTH 54: 6 www.cja-jca

BackgroundForeign body ingestion is common, especially in the pediatric population. Plans for retrieval should be tailored to the specific esophageal foreign bodies.Case presentationWe present a difficult to retrieve esophageal foreign body in a 3-year-old girl who ingested a 2 cm glass pebble. Intraoperatively, attempts using conventional optical forceps and retrieval baskets were unsuccessful due to the size and smooth texture of the object. A novel strategy using double Fogarty embolectomy balloon catheters for retrieval of blunt esophageal foreign bodies was devised and described.ConclusionThe double fogarty retrieval technique described appeared to be safe and efficacious, allowing for extraction of large esophageal foreign bodies under direct visualization.

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