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Airway management of patients undergoing thyroidectomy for Retrosternal Goitre (RSG) poses a unique challenge. Associated comorbidities, manipulation of the airway by the surgeons, airway compromise during induction, intubation, intraoperative and postoperative period can contribute to adverse events. We describe anaesthetic management of a patient with long standing goitre for 61 years with retrosternal extension with tracheal narrowing and compression for thyroidectomy. We secured the airway in an awake, spontaneously breathing patient under topical anaesthesia and sedation using direct laryngoscopy. Airway management of RSG is challenging at every phase of anaesthesia. Maintaining airway patency, vigilance and preparedness are keys to the success of intubation.

Introduction: Laparoscopic cholecystectomy surgery causes patients to have postoperative discomfort due to pain caused by incisions on the anterior abdominal wall. With the introduction of peripheral nerve blocks, the dosage of systemic analgesics can be significantly reduced and thereby the side-effects that may be caused by them. Oblique Subcostal Transversus Abdominis Plane (OSTAP block) which is a variant of the TAP block provides superior analgesia for supraumbilical procedures. Aim: To compare the efficacy of ultrasound-guided OSTAP block using 0.35% ropivacaine with saline OSTAP block in patients undergoing elective Laparoscopic cholecystectomy surgery. Materials and Methods: Forty-two ASA 1 and 2 patients posted for elective laparoscopic cholecystectomies were randomly assigned into two groups. Group A received bilateral OSTAP block with 0.35% ropivacaine and Group B received bilateral OSTAP block with sterile normal saline after the induction of general anaesthesia. Intraoperatively, the dose of opioid required during surgery and postoperatively pain score, opioid consumption, Postoperative Nausea and Vomiting (PONV) and Post Anaesthesia Care Unit (PACU) length of stay were evaluated. For all statistical evaluations, a two-tailed probability p-value of