Laryngospasm

Laryngospasm is a complication that all pediatric anesthesia providers must be able to successfully diagnosis and treat. The risk factors include but are not limited to recent upper respiratory infection, history of asthma, preschool-age child, airway surgery, and light anesthesia. Laryngospasm can be defined as either partial laryngospasm with residual opening of the glottis or complete laryngospasm where there is no air movement. Prevention is obtained by limiting risk factors; waiting 6 to 8 weeks after upper respiratory infection symptoms have resolved if possible, smoking cessation, suctioning of residual secretions, and maintaining an adequate depth of anesthesia during crucial times like intubation and extubation. Treatment includes jaw thrust with positive pressure and 100% oxygen, followed by a subhypnotic dose of propofol if the laryngospasm does not break, then finally succinylcholine if all other methods have failed. With treatments that depress respiratory drive, delirium can result and must be diagnosed correctly.