Shoulder and head elevation improves laryngoscopic view for tracheal intubation in nonobese as well as obese individuals.

Study Objective: To determine whether shoulder and head elevation, such that the patient's ear lies at or higher than the sternum ("ramp"), improves laryngoscopic grade in adult patients of various body mass index (BMI) values.

Design: Prospective, unblinded study, with patients and laryngoscopists acting as their own controls.

Setting: Operating room of a university-affiliated hospital.

Malignant Hyperthermia and Electroconvulsive Therapy.

A 30-year-old man with a personal and family history of malignant hyperthermia and a 7-year history of psychiatric illness unresponsive to various psychotropic medications benefitted from electroconvulsive therapy given in combination with clozapine. Volatile inhalation anesthetics and a depolarizing muscle relaxant (succinylcholine) were assiduously avoided. Dantrolene was administered intravenously before the first treatment but was not used for the remainder of the treatments.