Tracheal intubation

Tracheal intubation is possible without the use of a relaxant when the patient is weak, has depressed airway protective reflexes, or has received a generous dose of a sedative or anesthetic agent. Intubation may also be performed following local analgesia to the pharynx and larynx. However, the use of a muscle relaxant facilitates intubation and reduces the potential for trauma. It is also particularly useful when the airway has to be secured with the minimum of delay, and in these cases succinylcholine is the drug of choice unless otherwise contraindicated. It must always be remembered that a muscle relaxant must never be administered to a patient unless the operator is certain that the airway can be maintained by some other means (e.g. face mask and oral or nasopharyngeal airway) if tracheal intubation should prove to be difficult.

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