I think others may have commented on this before, but it seems like a good time to bring it up again, intubating without relaxant.
This idea wasn't even mentioned during (my) residency. First day in the peds room here in PP, one of the old guys came in to see how I was doing, and politely suggested getting the kid deep with prop, then using no relaxant. Now I do all my tonsils etc that way. I even have done it with some adults. Heck, when I don't use succ and go with vec (90% of the time) I don't even really wait long enough for it to really kick in.
In other words, if you time sliding that tube in and don't bang around, you really don't need relaxant. But I can see why we never did that as a resident. I find the biggest advantage of relaxant is allowing one to ventilate a hefty patient. Once the chest relaxes, ventilation is usually fairly easy with anyone, unless there is also lots of facial hair and/or no teeth.
What do others think?
Tuck