Successful use of rocuronium and sugammadex in an anticipated difficult airway scenario.
نویسندگان
چکیده
Neuromuscular blocking agents are often avoided in anticipated difficult airway scenarios. However to facilitate jet ventilation, muscle relaxants are useful. We report a case of a potentially threatened airway in a 21-year-old with a large infraglottic pedunculated polyp. In this case rocuronium was used on induction to facilitate subsequent jet ventilation and periglottic laser ablation of the tumour As the duration of the surgery was not predictable, the intention was to use sugammadex at the end to ensure complete reversal of muscle relaxation. This strategy also provided a quick rescue option if there was a sudden loss of the airway.
منابع مشابه
Sugammadex and the cannot intubate / cannot ventilate scenario in patients with predicted difficult airway ( 1 )
Editor—Curtis and colleagues presented an interesting case in which a patient with anticipated difficult intubation was paralysed with rocuronium and developed a cannot intubate/cannot ventilate (CI/CV) situation. Sugammadex was administered, resulting in successful recovery of the patient’s motor strength, but ventilation was still impossible, presumably due to swelling of the airway and bleed...
متن کاملSugammadex and the cannot intubate/cannot ventilate scenario in patients with predicted difficult airway (1). Letter 3.
Editor—Curtis and colleagues presented an interesting case in which a patient with anticipated difficult intubation was paralysed with rocuronium and developed a cannot intubate/cannot ventilate (CI/CV) situation. Sugammadex was administered, resulting in successful recovery of the patient’s motor strength, but ventilation was still impossible, presumably due to swelling of the airway and bleed...
متن کاملUse of sugammadex in a 'can't intubate, can't ventilate' situation.
A 78-yr-old woman presented for a panendoscopy to investigate dysphonia and dysphagia. Intubation was anticipated to be difficult but possible, and mask ventilation was anticipated to be possible. After induction of anaesthesia and after three attempts at intubation, a 'can't intubate, can ventilate' situation deteriorated to a 'can't intubate, can't ventilate' (CICV) situation. Rocuronium-indu...
متن کاملA persistent 'can't intubate, can't oxygenate' crisis despite rocuronium reversal with sugammadex.
A 'can't intubate, can't oxygenate' airway crisis is a rare event which most anaesthetists will never experience during their career(1,2). This report highlights the outcome of time-critical decisions in a potential airway catastrophe. Rocuronium was used as an alternative muscle relaxant for rapid sequence induction. The use of sugammadex in 'can't intubate, can't oxygenate' crises is discusse...
متن کاملReversal of Vecuronium-induced Neuromuscular Blockade with Sugammadex in a Child with Moebius Syndrome after Accidental Extubation
Sugammadex chemically encapsulates rocuronium and vecuronium, thereby rapidly terminating the neuromuscular blockade induced by these agents. Although the experience with the use of sugammadex in children under 2 years of age is limited, it may be considered in specific clinical contexts. We present a case where spontaneous efficient respiratory effort was resumed after reversal of vecuroniumin...
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ورودعنوان ژورنال:
- Anaesthesia and intensive care
دوره 38 2 شماره
صفحات -
تاریخ انتشار 2010