Goitre has always remained a known risk factor for difficult airway. The never ending challenges are being faced by an anaesthesiologist all through the pre-operative, intra-operative and post-operative period. We report the anaesthetic management of world’s second largest and India’s largest goitre with tracheal narrowing and deviation which further required re-exploration for bleeding from the surgical site. Though awake fiberoptic intubation remains procedure of choice in this scenario but carries failure rate. Also availability of flexible fiberoscope is still limited, mandating use of alternate techniques which sometimes provide better alternative to failed fiberoptic intubation.

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Dr Ankita Chandel

Ex registrar, Department of Anaesthesia IGMC, Shimla