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Pediatric laryngospasm: prevention and treatment
Achir Ahmad Al-alami1, Maria Markakis Zestos, Anis Shehata Baraka
1Children's Hospital of Michigan, Wayne State University, Detroit, Michigan, USA.
Insights
Laryngospasm prevention involves identifying risk factors and taking precautions. Experienced anesthesiologists and airway management are key to reducing incidence and effectively treating this airway obstruction.
Area of Science:
- Anesthesiology
- Pediatric Anesthesia
- Airway Management
Background:
- Laryngospasm is a critical concern during anesthesia.
- Understanding risk factors is crucial for prevention and management.
Purpose of the Study:
- To review laryngospasm risk factors.
- To discuss prevention and treatment techniques.
- To summarize management in organized algorithms.
Main Methods:
- Review of recent endoscopic studies.
- Analysis of risk factors and anesthetic techniques.
- Evaluation of treatment modalities.
Main Results:
- Laryngospasm is a complete airway obstruction requiring intervention.
- Risk factors include parental history of URI in children.
- Pediatric anesthesiologists and intravenous anesthesia reduce incidence.
- Muscle relaxants and deep LMA removal decrease risk.
- Succinylcholine is an intramuscular treatment option.
Conclusions:
- Identifying risk factors and precautions are vital for laryngospasm prevention.
- Experienced anesthesiologists and effective airway management are essential.
- Pharmacological adjuncts aid treatment, particularly for novice practitioners.
Purpose Of Review:
The purpose of this review is to discuss the risk factors associated with laryngospasm and the techniques used for prevention and treatment. We also summarize the prevention and treatment modalities in organized algorithms.
Recent Findings:
According to recent endoscopic studies, laryngospasm is always complete, thus airway management and intravenous therapy are indicated. Parental history of children having upper respiratory infection is associated with increased risk of laryngospasm. Anesthesia administered by a pediatric anesthesiologist is associated with lower incidence of laryngospasm. Intravenous anesthesia is associated with lower incidence of laryngospasm than inhalational anesthesia. In tracheal intubation, the use of muscle relaxants decreases laryngospasm. Deep laryngeal mask airway removal is associated with lower incidence of laryngospasm in sevoflurane or isoflurane anesthesia. In no intravenous line situation, laryngospasm can be treated with succinylcholine administration by intramuscular, intraosseous and intralingual routes.
Summary:
Identifying the risk factors and taking the necessary precautions are the key points in prevention of laryngospasm. An experienced anesthesiologist is associated with lower incidence of laryngospasm. Airway management is the most essential part of treatment of laryngospasm. Drugs can be used as an adjunct in treatment of laryngospasm, especially when anesthesia is administered by beginners.
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