ABSTRACT
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.
Subject(s)
Androstanols/pharmacology , Intubation, Intratracheal/methods , Neuromuscular Nondepolarizing Agents/pharmacology , gamma-Cyclodextrins/pharmacology , Adult , High-Frequency Jet Ventilation , Humans , Male , Polyps/surgery , Rocuronium , Sugammadex , Young AdultABSTRACT
We present four patients in whom a "ketofol" (ketamine 200 mg and propofol 200 mg) infusion was used in conjunction with regional anaesthesia. The patients were considered 'high risk' due to their medical condition or age. The ketofol proved safe and effective in all four cases. Advantages of this technique included analgesia, airway preservation, maintenance of spontaneous respiration, haemodynamic stability and rapid recovery.
