NARCO-SS is a valid risk stratification tool that is better than the ASA-PS in discriminating children with adverse perioperative outcomes. The poor calibration of both scores suggests neither can reliably predict perioperative outcomes in individual patients. Modification of neurological and airway categories may improve the predictive accuracy of the NARCO-SS.

In paediatric patients, airway management can be challenging due to unique anatomical and physiological variations. Hence, a thorough history, examination and pre-operative planning are essential in securing difficult airway in paediatrics. We report a case of a 7-month-old infant with rhabdomyosarcoma of the upper lip with anticipated difficult airway. The airway was managed with three different conventional techniques (modified nasal trumpet, supraglottic airway and direct laryngoscopy) for three different procedures in the same infant. The procedures were uneventful and recovery was good. This case report emphasises the use of conventional techniques in the management of difficult airway.

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Excision of tumors in the thoracic inlet entail a risk of injury to subclavian vessels due to their close proximity. A right radial artery line can sensitively and continuously monitor the occurrence of right subclavian artery compression and warn the surgeon of its proximity and prevent injury. We describe a case of thoracic inlet tumor in a 12-year-old child, wherein the use of radial artery pressure monitoring guided the surgeon to separate the subclavian artery from the tumor to which it was adherent.

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