Management of neuromuscular block: time for a change?

Successful use of Rocuronium and Sugammadex in an Anticipated Difficult Airway Scenario

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.