Awake fiberoptic intubation in a pediatric patient with cervical spine injuries on a halo-vest: a case report.

Awake fiberoptic intubation (AFOI) in pediatric patients remains a continuous challenge for the anesthetists, and is considered more cumbersome a procedure as compared to the adult population. The coexistence of unstable cervical spine injuries, although rare, but complicates the procedure even more. Proper pre-planning, adequate sedation and analgesia and the patient’s conscious cooperation are needed to ensure success. We describe a stepby- step approach to a successful AFOI in a 12-year-old child who had atlantooccipital instability and had a halo-vest on. Titrated dose of sedation and analgesia, obtunding airway reflex and patient’s cooperation is a key to successful AFOI in this patient. Abbreviations: AFIO: Awake fiberoptic intubation; OMF: Oromaxillofacial; BMI: body mass index; TCI: Targetcontrolled infusion. [ABSTRACT FROM AUTHOR]