Muscle relaxants and airway management.

摘要

To the Editor:-The article by Schmidt et al. and the accompanying editorial by Boylan and Kavanagh raise a very important issue, which is the place of neuromuscular blocking drugs (NMBDs) in anesthetic practice. Schmidt et al. state that "The use of muscle relaxants can cause severe hypoxia if the trachea cannot be intubated and the patient cannot be ventilated."1 We would be grateful if they could tell us on what evidence they base this statement. With respect, we think they may be falling into the well-known medical trap of confusing subsequence with consequence. In our opinion a more realistic and up-to-date statement would be "If mask ventilation is impossible, the evidence suggests that an NMBD will permit ventilation or intubation."