Cervical stabilization with halo fixation: Anesthetic implications-Case Reports

Halo fixation is often used to provide stability in patients with unstable cervical spine. These fixation devices pose unique challenges to the anesthesiologists encountered while securing an airway. Management of airway in patients with halo fixation is complicated by the fixed position, limited access to the face, and immobilization of neck. We managed two different patients, one in which halo fixation was done for atlanto-axial dislocation [AAD]; and the other, who came with halo fixation and underwent wound debridement under general anesthesia. In the former case, procedure was carried out with laryngeal mask anesthesia and patient breathing spontaneously whereas, in the later case, procedure was performed after securing the airway using awake fiberoptic intubation technique

Intraoperative bronchospasm under spinal analgesia: a case report

The involvement of respiratory system occurs mainly as a result of a high spinal block. Our case describes the unusual effect of mid-spinal analgesia. We encountered bronchospasm in an otherwise healthy patient undergoing inguinal hernia repair under subarachnoid block. The highest level of block was T6. The anxiety of the patient further aggravated the symptoms. This is probably the first reported incident of bronchospasm as a result of spinal anesthesia. We speculate the role of unblocked parasympathetic system in the causation of this respiratory complication