Should general anesthesiologists be certified to perform anesthesia for patients with morbid obesity undergoing bariatric surgery: A national web-based cross-sectional survey.

Background: Bariatric surgery in Saudi Arabia has become one of the most performed surgical procedures for weight loss surgery (WLS). The aim of this survey is to highlight the importance of education and training in bariatric anesthesia (BA). Methods: An Internet-based cross-sectional survey was conducted to examine the percentages of general anesthesiologists among respondents who supported the need for formal structured training in BA as the primary outcome. A 41 items questionnaire on different aspects of BA included in this survey. All anesthesiologists in KSA participated in this survey. Results: 42% responded giving anesthesia for bariatric surgery/year between 25 and 50% of cases/year. 22% responded performing 25-50 cases/month, 21% from 10-25 cases, and 14% from 50-100 cases. Compared with how many elective bariatric surgical procedures performed in your center/month revealed significant differences (P < 0.05), 39% responded with no dedicated team in their center, 14% for <10 cases a month, 9% between 25 and 50 cases a month. Compared to the number of cases performed by non-bariatric anesthetists revealed non-significant differences (P > 0.05), upon asking on how many trained/skilled anesthesiologists in bariatric anesthesia in your center, 24% reported none, 4% only one, 21% 2-5 anesthesiologists, 12% 5-10 anesthesiologists, and 19% of the respondents reported more than 10 anesthesiologists specialized in BA. Conclusion: We believe in education and training in bariatric anesthesia. Residents' rotation in BA should be included in their curriculum. A dedicated fellowship program to be developed at a national level as well as courses and workshops.

Airway management of a child with mucopolysaccharidosis undergoing cervical spine surgery: A case report.

"Mucopolysaccharidosis" (MPS) is a rare, autosomal recessive lysosomal storage disease characterized by deficiencies in 11 different lysosomal enzymes involved in the metabolism of glycosaminoglycans (GAGs) leading to its accumulation, the condition which results in anatomic abnormalities and multi-organ dysfunction that increases the risk of anesthesia complications. The patterns of accumulation form the basis of MPS classification into seven types of progressive diseases. Most of the MPS types have facial and oral characteristics that increase the risk of airway management. We are reporting a case of MPS with a challenging airway, an 11-years-old boy diagnosed with MPS type VI with a prominent facial character planned for cervical spine fixation versus decompression, successfully managed with fiberoptic bronchoscopy (FOB) guided by video laryngoscopy (VL).