Klippel-Feil syndrome (KFS) is a rare syndrome characterized by a classic triad comprising a short neck, a low posterior hairline, and limited neck mobility due to fused cervical vertebrae. We hereby report anesthetic management for pyeloplasty of KFS patient with micrognathia and restricted mouth opening. A careful preoperative evaluation to exclude other anomalies associated with   KFS was done. The patient had restricted mouth opening, retrognathia, and limited cervical mobility due to cervical vertebral fusion, with sprengels deformity, aortic arch abnormality, sensory neuronal hearing loss and urologically pelviuretric obstruction on both sides. As difficult intubation was predicted, video laryngoscopy was our first choice for gaining control of the patient’s airway. In the operating room, tracheotomy equipment was kept ready if a perioperative surgical airway control was required. Surgery was uneventful. Careful preoperative examination and preparation for difficult airway management are important for KFS patients with micrognathia.

Introduction: Difficult intubation carries almost one third of deaths due to failure to intubate or ventilate. We performed current study to compare tracheal intubation using Awake Fiberoptic intubation and using Intubating laryngeal mask airway in patients with difficult airway. Method-Two groups of 40 ASA I&II with MPC I,II,III were randomized for intubating trachea with awake Fiberoptic and Intubating laryngeal mask airway. Changes in hemodynamics monitored through all procedure till 10 min after intubation. Assessment done for ease of intubation,no.of attempts,complications like sore throat,arrythmias.Result-No significant difference found in demographic data as well in SBP,DBP,MAP,SPO2 in both groups. At 5 min after intubation mean heart rate changes were significant between both the groups. Maximum HR changes seen at 5 minutes as increase in HR of 18.57 from baseline in group F whereas in group I it was just 13.42.Conclusion-Intubation with Fiberoptic & Intubating laryngeal mask airway is equally successful and suitable with low complication rate in difficult airway.