As I understand it, there is a genetic test in development (commercially available?) for MH. This would make the issue a non-issue would it not?

Thank you kindly for your response.

As an update, I gave her a spinal without any problems (single pass, 27G Sprotte needle) and a superb block.

Unfortunately, she developed what seemed like a dural puncture headache on day 2. It was mild enough for her to function, but was clearly postural. It went away with conservative measures on about day 4. I'm very glad I did not have to perform a blood patch on her!  :P

I had a 6 year old child who was fasted for all food and drinks for 6 hours for an elective procedure, except he had been chewing gum for 2 hours up until 15 minutes prior to his surgery. The nurses had told him and his parents that the anesthesiologist would cancel his surgery because of this.

I wasn't too fussed and proceeded, uneventfully. I can't imagine that chewing gum could generate enough saliva or even gastric fluids sufficient to cause a risk of aspiration. I did a quick literature check but found nothing.

Anyone care to enlighten me?

We have the Cook Arndt Bronchial blocker which is a three-way accessory that attaches to any ETT. It allows the passage of a pediatric bronchoscope.
I have uploaded some pics below which should makes its use self-explanatory.

Hey, this is going to put us out of business! Anyone will be able to intubate the difficult airway!

We had a woman referred to us by the antenatal clinic (!). This is a miracle in itself but not the point of the story.

This woman is 34 weeks pregnant, and with a high grade placenta previa. The Obs Gobs guys are doubtful that it will shift between now and 38 weeks when they plan to do an elective Cesarean Section.

The problem is that she has had Harrington rods inserted during her teens to correct a severe scoliosis. She has no X-rays from  that time, and refuses an X-Ray before the baby is born. Her scar extends down to the mid-lumbar area. She is otherwise well.

I would like to give this woman a regional anesthetic, either an epidural or preferably a spinal, but I am not sure what degree of anatomical disturbance she has had resulting from the Harrington rods. I am assuming an epidural would be pachty and possibly ineffective because of the scarring and/or deformation in this area. Assuming I can get a spinal in, would it be effective? or would there be too much tethering/scarring/streching of the dura and spinal canal to render it inefective?

I would appreciate whatever input into this problem.

Where I work, once the child is induced, I get my assistant (resident or nurse) to hold the mask while I place an IV. Once that's done, then I or my assistant secrues the airway. Thisworks well only if the child has a fairly easy airway to maintain with bag and mask, and if my assistant is fairly experienced at holding a mask on a child.