Below a cardiac temperature of 28C, the heart may suddenly and spontaneously arrest. As your vocal cords slowly relax and open, you may hear a high-pitched sound (stridor). It normally passes quickly and is not dangerous, but some . They can determine the cause of your laryngospasms and recommend an appropriate treatment plan. In addition, in complete laryngospasm, there is no air movement, no breath sounds, absence of movement of the reservoir bag, and flat capnogram.3Finally, late clinical signs occur if the obstruction is not relieved including oxygen desaturation, bradycardia, and cyanosis.3. Anesth Analg 2007; 105:34450, Mamie C, Habre W, Delhumeau C, Argiroffo CB, Morabia A: Incidence and risk factors of perioperative respiratory adverse events in children undergoing elective surgery. Taking an antacid or acid inhibitor for a few weeks may help diagnose the problem by the process of elimination. Anesth Analg 1985; 64:11936, Lee CK, Chien TJ, Hsu JC, Yang CY, Hsiao JM, Huang YR, Chang CL: The effect of acupuncture on the incidence of postextubation laryngospasm in children. To avoid significant morbidity and mortality, the use of a structured algorithm has been proposed.8,70One study suggests that if correctly applied, a combined core algorithm recommended for the diagnosis and management of laryngospasm would have led to earlier recognition and/or better management in 16% of the cases.70These results should encourage physicians to implement their own structured algorithm for the diagnosis and management of laryngospasm in children in their institutions. Laryngospasm remains the leading cause of perioperative cardiac arrest from respiratory origin in children.1, The upper airway has several functions (swallowing, breathing, and phonation) but protection of the airway from any foreign material is the most essential. Anesth Analg 2007; 104:26570, Bordet F, Allaouchiche B, Lansiaux S, Combet S, Pouyau A, Taylor P, Bonnard C, Chassard D: Risk factors for airway complications during general anaesthesia in paediatric patients. Advertisement cookies are used to provide visitors with relevant ads and marketing campaigns. If laryngospasms are due to anxiety, then anti-anxiety meds can help ease your spasms. The anesthesia staff has called for the fiberoptic intubation set and is preparing to perform fiberoptic intubation. However, the acquisition and the mastering of these skills during specialty training and their maintenance during continuing medical education represent a formidable challenge. Can J Anaesth 1988; 35:938, Fink BR: The etiology and treatment of laryngeal spasm. First-level studies evaluate the effect of training in a controlled environment (in simulation). ANESTHESIOLOGY 2010; 12:98592, McGaghie WC: Medical education research as translational science. Airway simulators and high fidelity mannequins are important teaching tools.73Simple bench models, airway mannequins, and virtual reality simulators can be used to learn and practice basic and complex technical skills. Past medical history was unremarkable except for an episode of upper respiratory tract infection 4 weeks ago. Anesth Analg 1991; 73:26670, Rachel Homer J, Elwood T, Peterson D, Rampersad S: Risk factors for adverse events in children with colds emerging from anesthesia: A logistic regression. To reverse laryngospasm after surgery with anesthesia, your medical team can perform treatments to relax your vocal cords and ease your symptoms. A computer-aided incidence study in 136,929 patients Acta Anaesthesiol Scand 1984; 28:56775, Burgoyne LL, Anghelescu DL: Intervention steps for treating laryngospasm in pediatric patients. Both reflexes are sometimes considered as a single phylogenetic reflex.20The neuronal pathways underlying upper airway reflexes include an afferent pathway, a common central integration network, and an efferent pathway.19. 1998 Nov;89(5):1293-4. If you have any of the conditions listed above, talk to your healthcare provider about ways to reduce your risk for laryngospasms. He has completed fellowship training in both intensive care medicine and emergency medicine, as well as post-graduate training in biochemistry, clinical toxicology, clinical epidemiology, and health professional education. , partial or complete) and of the bradycardia as well as the existence of contraindication to succinylcholine. font-weight: normal; Avoid breathing in through your nose. Epidemiology of Laryngospasm in Pediatric Patients Children are more prone to laryngospasm than adults, with laryngospasm being reported more commonly in children 1,000).2,5-7 In fact, the incidence of laryngospasm has been gery (i.e., otolaryngology surgery).2,5-7 Many factors may increase the risk of laryngospasm. He is one of the founders of theFOAMmovement (Free Open-Access Medical education) and is co-creator oflitfl.com,theRAGE podcast, theResuscitologycourse, and theSMACCconference. He had been fasting for the past 6 h. Preoperative evaluation was normal (systemic blood pressure 85/50 mmHg, heart rate 115 beats/min, pulse oximetry [SpO2] 99% on room air). There is a problem with (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7361892/). The first step of laryngospasm management is prevention. Anaesthesia 1998; 53:91720, Ko C, Kocaman F, Aygen E, Ozdem C, Ceki A: The use of preoperative lidocaine to prevent stridor and laryngospasm after tonsillectomy and adenoidectomy. Because these symptoms can be frightening, it is good to have a clear medical plan for prevention and treatment if you have any of these symptoms. Some people may experience recurring (returning) laryngospasms. If these medications help, please consult your doctor before taking them long term. American Academy of Allergy, Asthma and Immunology. Laryngospasm usually isnt life-threatening, but it can be a terrifying experience. Even though laryngospasms are scary when they happen, they usually dont cause serious problems. , otolaryngology surgery).2,5,,7Many factors may increase the risk of laryngospasm. ,5emergent procedures had a moderately higher risk than elective procedures for perioperative respiratory adverse events, including laryngospasm (17%vs. PEEP! Muscle relaxants are usually administered when initial steps of laryngospasm treatment have failed to relax the vocal cords. The next step in management depends on whether laryngospasm is partial or complete and if it can be relieved or not. } This scenario illustrates the potential risks of not managing your resources properly. Jpn J Physiol 2000; 50:314, Thompson DM, Rutter MJ, Rudolph CD, Willging JP, Cotton RT: Altered laryngeal sensation: A potential cause of apnea of infancy. It persists for a longer period in the context of respiratory syncytial virus infection, hypoxia, and anemia.21, The diagnosis of laryngospasm depends on the clinical judgment of the anesthesiologist. In the case of laryngospasm, basic appropriate airway manipulations such as chin lift, jaw thrust, and oral airway insertion in combination with CPAP can be demonstrated and practiced with these models. acute dystonic reactions; rarely associated with ketamine procedural sedation. ANESTHESIOLOGY 2001; 95:103940, Liu LM, DeCook TH, Goudsouzian NG, Ryan JF, Liu PL: Dose response to intramuscular succinylcholine in children. The afferent nerve involved in laryngeal closure reflex is the superior laryngeal nerve. Pediatr Emerg Care 1990; 6:1089, Woolf RL, Crawford MW, Choo SM: Dose-response of rocuronium bromide in children anesthetized with propofol: A comparison with succinylcholine. Coming to a Cleveland Clinic location?Hillcrest Cancer Center check-in changesCole Eye entrance closingVisitation, mask requirements and COVID-19 information, Notice of Intelligent Business Solutions data eventLearn more. Sign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID-19, plus expertise on managing health. After finishing his medical degree at the University of Auckland, he continued post-graduate training in New Zealand as well as Australias Northern Territory, Perth and Melbourne. Elsevier; 2021. https://www.clinicalkey.com. Laryngospasm is identied by varying degrees of airway obstruction with paradoxical chest move-ment, intercostal recession and tracheal tug. Thereafter, surgery was quickly completed, while tracheal extubation and postoperative recovery were uneventful. and bronchomotor reflexes, indicating that not only skeletal but also smooth muscles are involved in upper airway reflexes.19. Several studies suggest that deep extubation reduces this incidence, whereas others observed no difference.5,3435In one study, tracheal intubation with deep extubation was associated with increased respiratory adverse events rate (odds ratio = 2.39) compared with LMA removal at a deep level of anesthesia, whereas use of a facemask alone decreased respiratory adverse events (odds ratio = 0.15).35The difference between LMA and ETT was less evident when awake extubation was used (odds ratio = 0.65 and 1.26, respectively). Singapore Med J 1998; 39:32830, Warner DO: Intramuscular succinylcholine and laryngospasm. Although described in the conscious state and associated with silent reflux, laryngospasm is a problematic reflex which occurs often under general anaesthesia. This usually occurs because of stimulation during a light plane of anaesthesia but may also occur because of blood, secretions, and foreign bodies (e.g. However, children younger than 3 yr may develop 510 URI episodes per year. In a more recent series, the overall incidence of laryngospasm was lower8but the predominance of such incidents at a young age was still clear: 50 to 68% of cases occurred in children younger than 5 yr. These interventions include removal of the irritant stimulus,8,38chin lift, jaw thrust,39continuous positive airway pressure (CPAP), and positive pressure ventilation with a facemask and 100% O2.3,40,,43These maneuvers are popular because they have been shown to improve the patency of the upper airway in case of airway obstruction.42,4445Less commonly used airway maneuvers, such as pressure in the laryngospasm notch4,44and digital elevation of the tongue46also have been proposed as rapid and effective methods.8Overall conflicting results have been obtained regarding the best maneuver to relieve airway obstruction in children with laryngospasm. Mayo Clinic is a nonprofit organization and proceeds from Web advertising help support our mission. Click here for an email preview. ANESTHESIOLOGY 2007; 107:7149, Tait AR, Burke C, Voepel-Lewis T, Chiravuri D, Wagner D, Malviya S: Glycopyrrolate does not reduce the incidence of perioperative adverse events in children with upper respiratory tract infections. Dry drowning has been explained by mechanisms such as protracted laryngospasm and vagally mediated cardiac arrest triggered by contact of liquid with the upper airways. Laryngospasms are rare and typically last for fewer than 60 seconds. Can J Anaesth 2004; 51:45564, Goldmann K, Ferson DZ: Education and training in airway management. The patient is unconscious and initially breathing easily with an oral airway in place. include protected health information. It is a primitive protective airway reflex that exists to . Broaddus VC, et al. The anesthesiologist assesses that the head/neck could be placed in a more ideal position . Acta Anaesthesiol Scand 2009; 53:19, Larson CP Jr: Laryngospasmthe best treatment. It is still debated whether tracheal extubation should be performed in awake or deeply anesthetized children to decrease laryngospasm. We decided to omit it in the preventive and/or treatment algorithms of laryngospasm, although other authors have included it.3,8,66. Recently, a new technique with gentle chest compression has been proposed as an alternative to standard practice for relief of laryngospasm.47In this before-after study, extubation laryngospasm was managed with standard practice (CPAP and gentle positive pressure ventilation via a tight-fitting facemask with 100% O2via facemask) during the first 2 yr of the study, whereas in the following 2 yr, laryngospasm was managed with 100% O2and concurrent gentle chest compression. Laryngospasm is potentially life-threatening closure of the true vocal chords resulting in partial or complete airway obstruction unresponsive to airway positioning maneuvers. When it happens, the vocal cords suddenly seize up or close when taking in a breath, blocking the flow of air into the lungs.People with this . Breathe in slowly through your nose. These cookies will be stored in your browser only with your consent. Anesthesiology. (#2) With steroid and antibiotic, most patients will gradually improve. Identifying the risk factors and planning appropriate anesthetic management is a rational approach to reduce laryngospasm incidence and severity. Perianesthetic Management of Hypertrophic Cardiomyopathy, Copyright 2023 American Society of Anesthesiologists. The mother volunteered that he was exposed to passive smoking in the home. However, onset time to effective relief of laryngospasm is shorter than onset time to maximal twitch depression, enabling laryngospasm relief and oxygenation (within 60 s) in less time than time to maximum twitch depression.55Therefore, intramuscular succinylcholine is the best alternative approach if IV access is not readily available.56Another alternative for succinylcholine administration is the intraosseous route. You might experience multiple laryngospasms in a brief time but in most cases, each episode ends after about a minute. Paediatr Anaesth 2003; 13:437, Schreiner MS, O'Hara I, Markakis DA, Politis GD: Do children who experience laryngospasm have an increased risk of upper respiratory tract infection? ANESTHESIOLOGY 2006; 105:4550, Meier S, Geiduschek J, Paganoni R, Fuehrmeyer F, Reber A: The effect of chin lift, jaw thrust, and continuous positive airway pressure on the size of the glottic opening and on stridor score in anesthetized, spontaneously breathing children. 1).3The second step relies on the emergent treatment of established laryngospasm occurring despite precautions (fig. The cause of vocal cord spasms is often unknown, and it is usually in response to a trigger such as anxiety or acid reflux. Hobaika AB, Lorentz MN. The exercise is then followed by a debriefing session during which constructive feedback is provided. Principal effectors are respiratory muscles (diaphragm, intercostals, abdominals, and upper airway). Laryngospasm was treated by 50 mg propofol and manual positive pressure mask ventilation with 100% inspired oxygen. It occurs during general or local anesthesia, natural sleep (rapid eye movement phase of sleep), hypercapnia, and hypoxia, as well as various muscular, neuromuscular junction, or peripheral nerves disorders affecting the efferent neural pathway and effector organs of upper airway reflexes.19, This condition arises as a result of an exaggerated and prolonged laryngeal closure reflex that can be triggered by mechanical (manipulation of pharynx or larynx) or chemical stimuli (e.g. Children are more prone to laryngospasm than adults, with laryngospasm being reported more commonly in children (17.4/1,000) than in the general population (8.7/1,000).2,5,,7In fact, the incidence of laryngospasm has been found to range from 1/1,000 up to 20/100 in high-risk surgery (i.e. Necessary cookies are absolutely essential for the website to function properly. Most of the time, your healthcare provider can diagnose laryngospasm by reviewing your symptoms and medical history. This rare phenomenon is often a symptom of an underlying condition. We use cookies on our website to give you the most relevant experience by remembering your preferences and repeat visits. Manual facemask ventilation became difficult with an increased resistance to insufflation and SpO2dropped rapidly from 98% to 78%, associated with a decrease in heart rate from 115 to 65 beats/min. These are the reasons why inhalational induction conducted by nonspecialized anesthetists remains associated with an increased risk of laryngospasm.2,5,18In children with hyperactive airways, there are now several arguments in favor of IV induction with propofol versus inhalational induction. This content does not have an Arabic version. Insufficient depth of anesthesia is one of the major causes of laryngospasm. Hold your breath for five seconds, then repeat until the laryngospasm stops. Treatment of laryngospasm. Laryngospasm scenario. Laryngospasm (luh-RING-o-spaz-um) is a condition in which your vocal cords suddenly spasm (involuntarily contract or seize). People with laryngospasm are unable to speak or breathe. Laryngospasm Administer 100% oxygen via nasal mask Suction the oropharynx, hypopharynx, and nasopharynx with a tonsil suction tip Suction/remove all blood, saliva, and foreign material from the oral cavity Pack the surgical site to prevent bleeding into the hypopharynx Draw the tongue and/or mandible forward Assist the patient's inspiratory effort with posi-tive-pressure ventilation with 100% oxygen. Pulm Pharmacol Ther 2004; 17:37781, Suskind DL, Thompson DM, Gulati M, Huddleston P, Liu DC, Baroody FM: Improved infant swallowing after gastroesophageal reflux disease treatment: A function of improved laryngeal sensation? Even though you may feel like you cant breathe, try to remember that the episode will pass. A 0.2-mg IV bolus dose of atropine was injected and IV succinylcholine was given at a dose of 16 mg, followed by tracheal intubation. In case of sale of your personal information, you may opt out by using the link. Prevention and Treatment of Laryngospasm in the Pediatric Patient: A Literature Review. He is a co-founder of theAustralia and New Zealand Clinician Educator Network(ANZCEN) and is the Lead for theANZCEN Clinician Educator Incubatorprogramme. Chris is an Intensivist and ECMO specialist at theAlfred ICU in Melbourne. scenario #2: the non-crashing epiglottitis patient. Laryngospasm is an emergency situation and must be promptly recognized. Jun 2005;14(3):e3. The patient will then develop worsened hypotension, requiring the start of an epinephrine infusion. Pulmonary complications. ANESTHESIOLOGY 2010; 113:2007, Roy WL, Lerman J: Laryngospasm in paediatric anaesthesia. A new episode of laryngospasm was immediately suspected. In most cases, a laryngospasm lasts for up to one minute, but it may feel much longer. Paediatr Anaesth 2008; 18:297302, Cohen MM, Cameron CB: Should you cancel the operation when a child has an upper respiratory tract infection? URI = upper respiratory tract infection. Two min after loss of eyelash reflex, a first episode of airway obstruction with inspiratory stridor and suprasternal retraction was successfully managed by jaw thrust and manual positive pressure ventilation. Portuguese. Keech BM, et al. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). [Laryngospasm]. Their motoneurons are located in the brainstem nucleus ambiguous and the adjacent nucleus retroambigualis. A 10-month-old boy (8.5 kg body weight) was taken to the operating room (at 11:00 PM), without premedication, for emergency surgery of an abscess of the second fingertip on the right hand. Complete airway obstruction is characterized by: Where is the laryngospasm notch? Larson CP Jr. Laryngospasmthe best treatment. Relative Risk (95% CI) of Laryngospasm in Children According to the Presence of Cold Symptoms, Household exposure to tobacco smoke was shown to increase the incidence of laryngospasm from 0.9% to 9.4% in children scheduled for otolaryngology and urologic surgery.12This strong association between passive exposure to tobacco smoke and airway complications in children was also observed in another large study.13. Functional cookies help to perform certain functionalities like sharing the content of the website on social media platforms, collect feedbacks, and other third-party features. These preliminary results are interesting and need to be confirmed by further studies. More needed than oxygen! Laryngoscope 2006; 116:1397403, Nishino T, Hasegawa R, Ide T, Isono S: Hypercapnia enhances the development of coughing during continuous infusion of water into the pharynx. Journal of Voice. However, some authors have observed that emergence from anesthesia tends to become the most critical period, possibly in relation to changes in practice including the use of laryngeal mask airway (LMA) and/or of propofol and newer inhalational agents.8, Laryngospasm can result in life-threatening complications, including severe hypoxia, bradycardia, negative pressure pulmonary edema, and cardiac arrest. Laryngospasm is usually defined as partial or complete airway obstruction associated with increasing abdominal and chest wall efforts to breathe against a closed glottis. ANESTHESIOLOGY 1998; 89:12934, Reber A, Paganoni R, Frei FJ: Effect of common airway manoeuvres on upper airway dimensions and clinical signs in anaesthetized, spontaneously breathing children. Based on a work athttps://litfl.com. Pediatr Pulmonol 2010; 45:4949, Afshan G, Chohan U, Qamar-Ul-Hoda M, Kamal RS: Is there a role of a small dose of propofol in the treatment of laryngeal spasm? Advertising revenue supports our not-for-profit mission. Paediatr Anaesth 2004; 14:15866, Olsson GL, Hallen B: Laryngospasm during anaesthesia. Sci Transl Med 2010; 2:19cm8. These cookies help provide information on metrics the number of visitors, bounce rate, traffic source, etc. The goal is to slow your breathing and allow your vocal cords to relax. If you or someone youre with is having a laryngospasm, you should: In addition to the techniques outlined above, there are breathing exercises that can help you through a laryngospasm. In children, an artificial cough maneuver, including a single lung inflation maneuver with 100% O2immediately before removal of the ETT, is useful at the time of extubation because it delays or prevents desaturation in the first 5 min after extubation in comparison with a suctioning procedure.36Although not demonstrated in this study, this technique could reduce laryngospasm because when the endotracheal tube leaves the trachea, the air escapes in a forceful expiration that removes residual secretions from the larynx. Can J Anaesth 2010; 57:74550, Sanikop C, Bhat S: Efficacy of intravenous lidocaine in prevention of post extubation laryngospasm in children undergoing cleft palate surgeries. The question of whether using propofol or muscle relaxant first is a matter of timing. 9500 Euclid Avenue, Cleveland, Ohio 44195 |, Important Updates + Notice of Vendor Data Event. He is actively involved in in using translational simulation to improve patient care and the design of processes and systems at Alfred Health. The procedure was expected to be very short, and general anesthesia with inhalational induction and maintenance, but without tracheal intubation, was planned. In the largest study published in the literature (n = 136,929 adults and children), the incidence of laryngospasm was 1.7% in 09 yr-old children and only 0.9% in older children and adults.7The highest incidence (more than 2%) was found in preschool age groups. IV line insertion should also be delayed until deep anesthesia (regular ventilation with large tidal volume, eyeballs fixed with pupils centered in myosis or moderately dilated) is achieved. Experimental evidences and anecdotal reports indicate that intraosseous and IV injection behave similarly, resulting in adequate intubating conditions within 45 s (1 mg/kg).57In children in whom succinylcholine is contraindicated, rocuronium administered at a dose of two to three times the ED95(0.9 to 1.2 mg/kg) may represent a reasonable substitute when rapid onset is needed.58,,60In addition, there is a possibility to quickly reverse the neuromuscular blockade induced by rocuronium using sugammadex if necessary.61. 2021; doi: 10.1016/j.jvoice.2020.01.004. 21,22. . Sufentanil (1 mcg) was given intravenously and the surgeon was allowed to proceed 5 min later. Med Educ 2010; 44:5063, Savoldelli GL, Naik VN, Park J, Joo HS, Chow R, Hamstra SJ: Value of debriefing during simulated crisis management: Oral, Russo SG, Eich C, Barwing J, Nickel EA, Braun U, Graf BM, Timmermann A: Self-reported changes in attitude and behavior after attending a simulation-aided airway management course. Fig. PubMed PMID: Salem MR, Crystal GJ, Nimmagadda U. [. This means that if nothing has occurred 46 h after the occurrence of a laryngospasm it is likely that the course will be uneventful. CPAP = continuous positive airway pressure; FiO2= fractional inspired oxygen tension; IM = intramuscular; PACU = postanesthesia care unit. Therefore, the injection of IV succinylcholine was required to treat this persistent laryngospasm. Mayo Clinic does not endorse companies or products. GERD: Can certain medications make it worse? The laryngospasm abates, and the patient becomes easier to ventilate. Airway management training, including management of laryngospasm, is an area that can significantly benefit from the use of simulators and simulation.73These tools represent alternative nonclinical training modalities and offer many advantages: individuals and teams can acquire and hone their technical and nontechnical skills without exposing patients to unnecessary risks; training and teaching can be standardized, scheduled, and repeated at regular intervals; and trainees' performances can be evaluated by an instructor who can provide constructive feedback, a critical component of learning through simulation.7475. Postoperative negative pressure pulmonary edema typically occurs in response to an upper airway obstruction, where patients can generate high negative intrathoracic pressures, leading to a postrelease pulmonary edema. 1. Therefore, giving IV atropine before IV injection of suxamethonium to treat laryngospasm is mandatory.66. Second-level studies attempt to document the transfer of skills to the clinical setting and patient care. However, a systematic approach based on the model of translational research has recently been proposed in medical education.79In this model, successive rigorous studies are conducted to evaluate the acquisition of skills and knowledge at different outcome levels. Preference cookies are used to store user preferences to provide content that is customized and convenient for the users, like the language of the website or the location of the visitor. Paediatr Anaesth 2002; 12:6258, Batra YK, Ivanova M, Ali SS, Shamsah M, Al Qattan AR, Belani KG: The efficacy of a subhypnotic dose of propofol in preventing laryngospasm following tonsillectomy and adenoidectomy in children. Laryngospasm is usually defined as partial or complete airway obstruction associated with increasing abdominal and chest wall efforts to breathe against a closed glottis.3,5,7In both partial and complete laryngospasm, signs of varying degrees of airway obstruction, such as suprasternal retraction, supraclavicular retractions, tracheal tug, paradoxical chest, and abdominal movements may be seen.3In addition, inspiratory stridor may be heard in partial laryngospasm but is absent in complete spasm. During the exercise, the instructor can observe and measure the performance of the trainees and compare them with the standards of performance mentioned in the algorithms. Cleveland Clinic is a non-profit academic medical center. Br J Anaesth 2001; 86:21722, Mark LC: Treatment of laryngospasm by digital elevation of tongue (letter). Learning outcomes are difficult to measure. If this happens to you, talk to your healthcare provider. During observation, she exhibits a sudden increase in respiratory effort and noise with ventilation. 5 Many high-acuity medical conditions can induce these. There are data supporting the efficacy of structured courses that integrate airway trainers and high fidelity simulation for airway management training.7677Recent evidence also supports the transfer of technical and nontechnical skills acquired during simulation to the clinical setting.78We therefore strongly encourage the integration of simulation-based training for pediatric airway management, including for the management of laryngospasm. According to Phil Larson: This notch is behind the lobule of the pinna of each ear. The purpose of this case scenario is to highlight keypoints essential for the prevention, diagnosis, and treatmentof laryngospasm occurring during anesthesia. PubMed PMID. tracheal tug, indrawing), vomiting or desaturation. Among all upper airway reflexes, it is the most resistant to deepening anesthesia, whereas the coughing reflex is the most sensitive. Inexperience of the anesthetist is also associated with an increased incidence of laryngospasm and perioperative respiratory adverse events.2,5,18Some factors are associated with a lower risk of laryngospasm: IV induction, airway management with facemask, and inhalational maintenance of anesthesia.5Induction and emergence from anesthesia are the most critical periods. This situation creates a risk of bronchopulmonary infection, chronic cough, and bronchospasm. Relaxation and breathing techniques may relieve symptoms and lessen the frequency or severity of laryngospasms in the future. The . For example, if laryngospasms are linked to GERD, then treating chronic acid reflux can also reduce your risk for laryngospasm. margin-right: 10px; Accessed Nov. 5, 2021. They can help figure out whats causing them. 2012 Aug;117(2):441-2. doi: 10.1097/ALN.0b013e31825f02b4. Last reviewed by a Cleveland Clinic medical professional on 02/11/2022. Laryngospasm (luh-RING-go-spaz-um) is a transient and reversible spasm of the vocal cords that temporarily makes it difficult to speak or breathe.
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