A ‘can't intubate, can't oxygenate’ airway crisis is a rare event which most anaesthetists will never experience during their career1,2. 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 discussed and highlights how, despite adequate reversal of neuromuscular blockade, the ‘can't intubate, can't oxygenate’ situation failed to resolve. An asymptomatic vallecular cyst was the causal factor in this scenario. Anaesthetic issues surrounding this pathology are discussed.
WongD.T., LaiK., ChungF.F., HoR.Y.Cannot intubate-cannot ventilate and difficult intubation strategies: results of a Canadian national survey. Anesth Analg2005; 100: 1439–1446.
2.
PerryJ.J., LeeJ.S., SillbergV.A., WellsG.A.Rocuronium versus succinylcholine for rapid sequence induction intubation. Cochrane Database Syst Rev2008; 2: CD002788.
KambleV.A., LillyR.B., GrossJ.B.Unanticipated difficult intubation as a result of an asymptomatic vallecular cyst. Anesthesiology1999; 91: 872–873.
5.
BisschopsM.M.A., HollemanC., HuitinkJ.M.Can sugammadex save a patient in a simulated ‘cannot intubate, cannot ventilate’ situation?Anaesthesia2010; 65: 936–941.
