Cis-atracurium with masseter muscle spasm: An unanticipated difficult endotracheal intubation and temporomandibular joint displacement: A case report

Masseter muscle spasm and displacement of temporomandibular joint under anaesthesia could be life threatening if an anaesthesiologist is not prepared. We present a case of 23 years old young lady, who otherwise healthy, having symptoms of abdominal pain and vomiting. Initial baseline workup showed a solitary gallstone and was then planned for urgent laparo-scopic cholecystectomy. The challenges faced in the perioperative period were the management of unanticipated masseter muscle spasm and difficult endotracheal intubation after administration of cisatracurium, and temporomandibular joint displacement.