A 44-year-old obese man presented for open reduction and internal fixation of an ankle fracture. To prevent myalgia, a defasciculating dose of vecuronium was given prior to rapid-sequence induction of anesthesia with succinylcholine. The patient developed agitation and profound hypoxemia prior to direct laryngoscopy and placement of an endotracheal tube. Lessons discussed in this chapter include prevention of fasciculation, succinylcholine-related myalgia, and pulmonary effects of obesity.
Direct Laryngoscopy Cervical Collar Oxyhemoglobin Desaturation Nondepolarizing Neuromuscular Blocker High Basal Metabolic Rate
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