iarjaccIARJACCIARJACC2709-1880https://doi.org/10.47310/iarjacc,2021.v02i01.028Anaesthetic Management of Retrosternal Goitre for Left Hemi Thyroidectomy – A Case ReportDeepakC.KoliRolyR.MishraVidhyaN.DeshmukhHemantH.MehtaConsultant Anaesthesiologist, Department of Anaesthesia and Pain Management, Sir H. N. Reliance Foundation Hospital and Research Centre, Mumbai, Maharashtra, IndiaDNB student, Department of Anaesthesia and Pain Management, Sir H. N. Reliance Foundation Hospital and Research Centre, Mumbai, Maharashtra, IndiaSenior Consultant Anaesthesiologist, Department of Anaesthesia and Pain Management, Sir H. N. Reliance Foundation Hospital and Research Centre, Mumbai, Maharashtra, India.Director and Head of the department, Department of Anaesthesia and Pain Management, Sir H. N. Reliance Foundation Hospital and Research Centre, Mumbai, Maharashtra, India.Large retrosternal goitre (RSG) usually poses a challenge to both anaesthesiologist as well as surgeon, as airway management in such case requires multidisciplinary discussion so as to formulate safe plan to secure the airway. Induction of anaesthesia and positioning may cause cardiorespiratory collapse and in severe cases cardiopulmonary bypass or veno-venous extracorporeal membrane oxygenation may be needed. Post-surgery extubating these patient constitutes another challenge due to risk of underlying tracheomalacia and may require prolonged ventilatory support or tracheal stenting. Authors describe successful management of a patient with long standing goitre for more than 20 years having retrosternal extension with tracheal narrowing and severe compression posted for left hemi thyroidectomy SOS total thyroidectomy. We secured the airway with intravenous induction by video laryngoscopy, after failed awake fiberoptic intubation.