Laryngospasm

Question 1

Laryngospasm

Answer 1

Sustained closure of the vocal cords as the muscles pull the cords together  perioperatively
You have instant airway obstruction  leads to hypoxia & bradycardia
Protects against aspiration as stomach contents irritate larynx

Question 2

Irritants:

Answer 2

o Secretions, blood, stomach contents
o Touching larynx  ETT (if no MR on board)
o Recent URTI or passive smoking (children)
o Light anaesthesia at the time of stimulus

Question 3

Prevention of laryngospasm

Answer 3

• Decrease the irritability of larynx
  Deep anaesthesia
  Topical anaesthesia  lignocaine spray
• Recent URTI cancel the surgery & come back 6 weeks later
• Kids  always prophylactically draw up Suxamethonium with blue needle attached for emergencies

Question 4

Sign of incomplete laryngospasm

Answer 4

stridor

Question 5

Signs of complete laryngospasm

Answer 5

Obstruction
tracheal tug
paradoxical respiratory movements of the thorax and abdomen
exaggerated abdominal mv
no audible breath sounds

Question 6

Treatment of partial spasm

Answer 6

Act quick - emergency
Remove any triggering stimulation
CPAP with 100% O2
deepen anaesthesia - propofol good dont use IAA because airway is blocked

Question 7

Treatment of complete spasm

Answer 7

Emergency
remove stimulus
jaw thrust, 100% O2
IPPV
Succinylcholine IV2mg/kg / IMI4mg/kg = definitive treatment!
Intubate