An Unusual Cause of Difficult Tracheal Intubation

A 45-yr-old, 80kg Sikh man from India is admitted for repair of scapholunate dislocation. His past medical history and physical exam is unremarkable. He is classified as American Society of Anesthesiologists physical status 1. He has a full beard and speaks English very well. He requests a regional block, but unfortunately it proves to be inadequate for the surgery. General anesthesia is decided upon. After preoxygenation, general anesthesia is induced with intravenous thiopental 250 mg, followed by succinylcholine 120 mg. Ventilation is easily accomplished by mask. At laryngoscopy, the patient’s jaw is found not to be relaxed. Trismus is considered. The nerve stimulator shows loss of twitch. A Macintosh #3 laryngoscope blade is passed into the pharynx with great difficulty caused by the very restricted mouth opening. Only the epiglottis is seen, but you manage to successfully place a #7 endotracheal tube in the trachea?


Endotracheal Tube Tracheal Intubation Mouth Opening Regional Block Difficult Tracheal Intubation 
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© Springer Science+Business Media, LLC 2008

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