Chapter 10 - Drugs for Airway Management

Summary

Correct choice and use of drugs is fundamental to airway management success and safety. This is true for both elective and emergency anaesthesia and at the start and end of anaesthesia. This chapter describes the key elements of drug selection for safe, effective airway management in both the awake and anaesthetised patient. Drugs can importantly facilitate airway management and influence conditions for tracheal intubation or inserting a supraglottic airway. Depression of reflexes and muscle tone can be provided by several hypnotics, but propofol is usually most effective. Neuromuscular blocking agents are not needed for many forms of airway management but can optimise conditions when necessary. The anaesthetist must be familiar with dosing and timing and with quantitative monitoring during reversal. Local anaesthesia may be the only safe choice in managing the difficult airway and sedation can enhance patient tolerance but maintaining adequate spontaneous ventilation is sometimes a challenge.