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Journal of Anaesthesiology Clinical Pharmacology | October-December 2013 | Vol 29 | Issue 4 563 formation.[2] Our patient had a history of nasal bleeding. It is plausible that he either aspirated blood or sustained tracheal injury during intubation, leading to local bleeding and pooling of blood in the dependent part of the ETT in supine position and clot formation. Surgical positioning and positive pressure ventilation led to distal clot migration and obstruction. Catheter advancement probably created a new channel for air passage through the clot or between the clot and ETT, improving ventilation. The waxing and waning of airway resistance occurred due to distal displacement and movement of clot in its vertical axis, leading to opening and closing of air channels. Later, the clot migrated and got impacted, completely blocking both the tip and Murphy’s eye of the ETT impeding ventilation.

Cardiac arrest associated with ranitidine and ondansetron combination in day care gynecologic surgery