Abstract

Background: As anaesthetists, we may constantly be in the learning curve of the management of difficult airway scenario. It can have a disastrous outcome if one is not adequately prepared with the right equipment. Over time there has been multiple ways to tackle difficult airway scenarios. Needless to say, appropriate airway gadgets are carefully chosen according to the surgery and patient characteristics. But what if these certain techniques fail? Then, what next? The inability to efficiently manage a difficult airway is the major cause of morbidity and mortality in anaesthetic practice. Here, we discuss 4 different case scenarios of difficult airway management.
 case reports:Case 1 was a pediatric patient with TMJ ankylosis, with mouth opening 4mm, in whom we used the fibreoptic technique. Case 2- A failed fibreoptic attempt in a case of recurrent Ca oral cavity where we secured the airway using Airtraq videolaryngoscope. Case 3- A patient with post burn contracture over front of neck and anterior shoulder where we decided to use intubating laryngeal mask airway for securing airway and Case 4- An obese female patient posted for hysterolaparoscopy where we used the Laryngeal Mask Airway Supreme.
 Conclusion: Effective usage of newer drugs, equipment and airway gadgets by technically skilled personnel, with sound clinical judgement are essential factors in reducing airway related adverse scenario and it is of utmost importance to keep these alternate gadgets handy and to be proficient with its usage.

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