Airway management in mucopolysaccharidosis: a retrospective case series review

Abstract Airway management can be difficult in surgeries of patients with mucopolysaccharidosis. We performed a retrospective review of 31 surgeries performed between 2015 and 2019. The mean age of the patients was 127.6 months. MPS-IV and MPS-VI were the most frequent subtypes. Orthopedic surgeries were the most common surgery type. Difficult intubation was seen in 10 procedures. All patients with difficult intubation were aged over 36 months. Video laryngoscopy was the most common intubation method. Seventeen patients were followed up in the intensive care unit. Although video laryngoscopy seems to be a safe method in these patients, one should always be prepared for alternative methods.

Epidural versus subaracanoid analgesia in ano-rectal surgery

Two groups of patients, 10 patients each were subjected to ano-rectal operations. One group received spinal analgesia, the other group received epidural analgesia. Mepivacaine 4% solution was used in spinal analgesia, and bupivacaine 0.5% in epidural analgesia. The onset of analgesia was very rapid in subarachnoid group after 2.5 minutes and delayed in epidural group after 8.5 minutes. The heamodynamic changes were gradual in both groups and not severe except for some cases. There was significant drop of the mean arterial blood pressure in both groups, but was more gradual in epidural group. Duration of analgesia was 142.3 minutes for spinal and 236 minutes for epidural analgesia. The need for systemic analgesics was delayed for epidural group up to 7.5 hours, but that for spinal was 2.7 hours. In 30% of epidural analgesia no post-operative analgesia was required while all the patients of spinal needed post operative analgesia. 40% of spinal suffered from post-operative headache. 20% of spinal group and 30% of epidural group complained of backache