Dohrmann T, Muschol NM, Sehner S, et al. - Given that children with mucopolysaccharidoses (subtypes I, II, III, IV, VI, and VII) or mucolipidoses frequently need anesthesia, but carry a high risk for perioperative adverse events, researchers undertook this retrospective analysis to define independent risk factors for perioperative adverse events in people suffering from mucopolysaccharidoses/mucolipidoses and assessed the interaction with the primary airway technique implemented. This analysis included people with mucopolysaccharidoses/mucolipidoses who received anesthesia at two high-volume centers from 2002 to 2016. A higher risk for perioperative adverse events was observed in mucopolysaccharidoses type I or type II vs in type III. The lowest risk for perioperative adverse events and lowest conversion rate was noted in relation to fiberoptic intubation through a supraglottic airway. A significantly higher risk for airway management problems was reported in relation to direct laryngoscopy vs indirect techniques. For supraglottic airway and direct laryngoscopy vs for fiberoptic intubation through a supraglottic airway, a significantly higher risk for respiratory adverse events was reported. Overall, the most significant independent risk factors for perioperative adverse events were disease subtype and primary airway technique. For the first tracheal intubation attempt in mucopolysaccharidoses/mucolipidoses children with a predicted difficult airway, preference should be given to indirect techniques.