Sevoflurane induction without muscle relaxant in two patients in which difficult intubation and ventilation are expected (case report)

Two emergency cases, one with morbid obesity and history of difficult intubation and the other with kyphoscoliosis, limited head-neck extension and additional skeletal anomalies are presented. The patients were intubated without neuromuscular blockade under spontenous breathing with sevoflurane. The quality of ventilation and intubation and hemodynamic reactions were recorded. Both patients were extubated at the end of the operation without any problems. The preparation, monitorization and procedure are discussed. Endotracheal intubation with sevoflurane induction without neuromuscular blockade may be an alternative in adult patients in which difficult intubation is expected.