NARCO-SS is a valid risk stratification tool that is better than the ASA-PS in discriminating children with adverse perioperative outcomes. The poor calibration of both scores suggests neither can reliably predict perioperative outcomes in individual patients. Modification of neurological and airway categories may improve the predictive accuracy of the NARCO-SS.

No abstract

Frontometaphyseal dysplasia (FMD), also called Gorlin-Cohen syndrome, is a rare hereditary X-linked dominant craniotubular bone disorder. The presentation describes the airway management of a 2-year-old child suffering from FMD with significant retrognathia, posted for major long bone corrective osteotomy. Induction with a combination of dexmedetomidine and ketamine preceded a successful endotracheal intubation under spontaneous ventilation.

Cutis laxa is a rare, inherited or acquired connective tissue disorder. It is characterized by loose, inelastic skin and various systemic involvements. Cutis laxa type III, described as de Barsy syndrome presents with ophthalmic opacification, skeletal involvement, cardiovascular involvement, mental and growth retardation. Intraoperative hyperthermia of the non-malignant variety with tachycardia is seen in 10% cases of cutis laxa type III. Given the rarity of cutis laxa syndrome, all cases require core and peripheral temperature monitoring.

In the practice of paediatric anaesthesia, intubation of trachea without using neuromuscular blocking agents is becoming commoner more so in conditions in which muscle relaxants are not preferred. Different combinations of drugs including opioids, intravenous agents and inhalational agents are being used for facilitating endotracheal intubation when muscle relaxants are not used. In this study we compared intubating conditions in paediatric patients after sevoflurane induction and propofol in two different doses. Materials and Methods: 80 children of 2 to 12 years age undergoing elective surgeries were divided into two groups P2 and P3 of 40 each. After sevoflurane induction and fentanyl 2mcg/kg I.V. group P2 received propofol 2mg/kg and group P3 received propofol 3mg/kg I.V. The two groups were compared with respect to intubating conditions and haemodynamic parameters. Results: Clinically acceptable intubating conditions were seen in all patients in both groups. Excellent intubating conditions were more in group P3 (87.5%) than group P2 (80%). Haemodynamic parameters showed no significant difference between the two groups. Conclusion:In paediatric patients, endotracheal intubation can be comfortably performed without muscle relaxants by using propofol and fentanyl with sevoflurane induction with no respiratory or haemodynamic adverse events. Propofol in a dose of 3mg/kg gives better intubating conditions than 2mg/kg without adverse haemodynamic effects, although 2mg/kg propofol also gives acceptable intubating conditions.