Paediatric anaesthesia
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Paediatric anaesthesia · Oct 2009
Case ReportsScoliosis repair in a teenager with Duchenne's muscular dystrophy: who calls the shots?
In this exchange, a clinician (the first author) presents a case scenario for comment by an ethicist (the second author). The case concerns a 15-year-old boy with Duchenne's muscular dystrophy requested palliative surgical correction of a 60 degree thoraco-lumbar scoliosis. The surgical team were initially reluctant to offer surgery given their assessment of the perioperative and postoperative risks (anesthetic review suggested an 80% chance of surviving the surgery and 50% likelihood of returning home), but the operation proceeded. The case raises issues of the rights of patients to insist on nonfutile but high risk surgery, risk perception, resource allocation, autonomy, and the integrity of clinicians.
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Paediatric anaesthesia · Oct 2009
Letter Case ReportsSuccessful intubation using a simple fiberoptic assisted laryngoscope for Treacher Collins syndrome.
A fiberoptic-assisted laryngoscope (FLS) (Acoma Medical Industry Co. Ltd., Tokyo, Japan) is a modified Macintosh laryngoscope with a tubular holder into which a fiberoptic bronchoscope can be inserted. We present three cases of Treacher Collins syndrome whose tracheas were successfully intubated with the aid of the FLS. These cases suggest that the FLS may be a useful alternative in the case of difficult pediatric intubation.