LAUSR

was supplemented with a target controlled infusion of propofol, with single co-administered doses of midazolam and fentanyl. Although we did not use bispectral index monitoring, physiological parameters and the professional experience of three consultant anaesthetists suggested that inadequate depth of anaesthesia was not the reason for increased vocal cord tone following sugammadex. Whilst we accept that this is not conclusive evidence for the untoward action of sugammadex on the vocal cords, we cannot help but think it supports the argument that sugammadex appears to have caused laryngospasm. However, even if this were proven to be the case, it is difficult to know what would be done differently in the future. In all cases cited in the original editorial, and here, the hypoxaemic episode resolved without any adverse outcomes. Sugammadex offers rapid reversal of muscle paralysis in a ‘can’t intubate, can’t ventilate’ situation, and perhaps it is necessary in the future for one to be aware of this potential effect, instead of sidelining a useful agent.