Management of failed intubation in a septic parturient

We describe a case in which regional anaesthesia for Caesarean section was initially avoided because of the presence of systemic infection. However, attempted induction of general anaesthesia resulted in failed tracheal intubation and so an epidural catheter was sited and used for the operation. Awake fibreoptic tracheal intubation was performed after surgery, when it was clear that ventilatory support on the intensive care unit would be needed. The relative risks of regional versus general anaesthesia when infection and difficult laryngoscopy coincide are discussed.