Laryngospasm

Hobaika, Adriano Bechara de Souza; Lorentz, Michele Nacur

doi:10.1590/s0034-70942009000400012

Cited by 14 publications

(16 citation statements)

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“…In addition to these, factors such as male sex, young age, bronchial asthma, respiratory tract infection, use of vagolytic drug, surgery and manipulation within the pharynx and larynx also precipitate laryngospasm in patients. Above all, manipulation of the airways such as laryngoscopy with tracheal intubation has been identified as the main risk factor for anesthesia induced laryngospasm [ 4 ]. Afferent stimulation from multiple receptors like mechanoreceptors, chemoreceptors, and thermal receptors induce laryngeal closure, triggering exaggeration of the glottis closure reflex and inducing laryngospasm.…”

Section: Discussionmentioning

confidence: 99%

“…Afferent stimulation from multiple receptors like mechanoreceptors, chemoreceptors, and thermal receptors induce laryngeal closure, triggering exaggeration of the glottis closure reflex and inducing laryngospasm. If not managed promptly by administering continuous positive airway pressure with 100% oxygen or succinylcholine intravenously, the obstruction of vocal cord leads to hypoxia, hypercarbia, aspiration, bronchospasm, arrhythmia, prolonged recovery, cardiac collapse, and eventually catastrophic death [ 3 4 ]. Besides, by inducing extremely negative intrapleural pressure due to airway obstruction, laryngospasm may induce fatal pulmonary edema [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

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Postoperative negative pressure pulmonary edema following repetitive laryngospasm even after reversal of neuromuscular blockade by sugammadex: a case report

Lee

et al. 2017

Korean J Anesthesiol

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Laryngospasm, an occlusion of the glottis, can occur at any time during anesthesia, and is associated with serious perioperative complications such as hypoxia, hypercabia, aspiration, bronchospasm, arrhythmia, prolonged recovery, cardiac collapse, and eventually catastrophic death. Importantly, postoperative negative pressure pulmonary edema (NPPE) is a rare, but well described life-threatening complication related to acute and chronic upper airway obstruction. Sugammadex well known for affirmatively reducing the postoperative pulmonary complications associated with residual neuromuscular blockade may have an indirect role in triggering the negative intrathoracic pressure by raising a rapid and efficacious respiratory muscle strength in acute upper airway obstruction. Herein, we report a case of postoperative NPPE following repetitive laryngospasm even after reversal of rocuronium-induced neuromuscular blockade using sugammadex.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Postoperative negative pressure pulmonary edema following repetitive laryngospasm even after reversal of neuromuscular blockade by sugammadex: a case report

Lee

et al. 2017

Korean J Anesthesiol

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“…The etiology of laryngospasm is unknown, but it may be due to an insufficient depth of anesthesia during tracheal intubation, a light plane of anesthesia during tracheal extubation, pain; or the presence of an airway irritant (such as a laryngoscope blade), an irritating volatile agent, a suction catheter, surgical debris, mucus, blood, or another foreign body. [ 1 2 3 ] Laryngospasm occurs in patients of both sexes and all ages. The incidence of laryngospasm reported to the Australian Incident Monitoring Study (AIMS) was 5%, and 22% of these cases occurred without an attributable cause.…”

Section: Introductionmentioning

confidence: 99%

Effect of intravenous lidocaine on the incidence of postextubation laryngospasm: A double-blind, placebo-controlled randomized trial

Aljonaieh

2018

Saudi J Anaesth

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Objectives:The study aimed to test the effect of intraoperative intravenous (IV) lidocaine on the incidence of postextubation laryngospasm in adult patients.Methods:The prospective randomized clinical trial was conducted at tertiary care hospital in Riyadh, between January and December 2012. Seventy-two patients undergoing laparoscopic cholecystectomy were randomly assigned to receive either placebo (n = 36) or IV lidocaine (n = 36), 1 mg/kg bolus after desflurane was discontinued. Laryngospasm was graded from 0 to 3 based on the absence or presence of signs and the severity of postextubation laryngospasm.Results:The study was terminated early by the data monitoring committee because of safety concerns due to an increased incidence of postextubation laryngospasm. Patient demographics were similar for both groups. The incidence of postextubation laryngospasm was 19.5% in the placebo group and 0% in the treatment (lidocaine) group; this difference was statistically significant (P = 0.017; 95% confidence interval, 4.6% to 36.0%).Conclusions:The cause of laryngospasm in our study was most likely the rapid increase in the concentration of inspired desflurane, which might have caused airway irritation. Therefore, we believe that pretreating patients at risk of developing laryngospasm with IV lidocaine could be effective.

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“…De forma geral, o laringoespasmo é considerado um exagero fisiológico do reflexo de fechamento glótico e/ou ausência de inibição do mesmo, de forma intensa e prolongada, o que impede a passagem de ar para os pulmões. O espasmo da laringe é uma complicação potencialmente grave cuja etiologia é multifatorial; contudo, na grande maioria das vezes decorre da manipulação de vias aéreas ou alterações morfofuncionais por lesão prévia [5,6,25,29].…”

Section: Introductionunclassified

Intervenção educacional relacionada à rotina de mensuração do balonete endotraqueal em um hospital universitário

Carvalho

Oliveira

2013

Rev. Cult. Ext. USP

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O suporte ventilatório mecânico invasivo promove benefícios. Entretanto, procedimentos que envolvem sua instituição podem gerar lesões em graus variáveis. A pressão do balonete que envolve o tubo traqueal, impedindo escape aéreo, não deve exceder à pressão de perfusão traqueal nem estar reduzida, a ponto de permitir a passagem de micro-organismos, ocasionando lesões teciduais e pneumonia aspirativa, respectivamente. A vigilância desta pressão como rotina de prevenção de complicações não é realizada em diversas unidades de tratamento intensivo. Assim, enfatizar estratégias preventivas parece ser um modo razoável de minimizá-las. A intervenção educacional objetiva difundir o conhecimento e valorizar aspectos importantes para melhoria da qualidade da assistência em saúde e promover redução das taxas de reintubação, tempo de internação hospitalar, morbi-mortalidade e custos hospitalares. O objetivo foi o de promover uma ação educacional, por meio da divulgação de instrumento informativo não verbal, no ambiente hospitalar. Valores obtidos dentro da faixa de normalidade esperada das pressões de cuff sofreram acréscimo de 11,36% para 20,51% após a intervenção. Assim, o modelo de intervenção educacional atingiu o objetivo esperado, embora seja recomendado e desejável que outras intervenções estejam futuramente associadas, visando complementar e enfatizar a importância da técnica para que haja benefícios mais expressivos neste âmbito.Palavras-chave: Balonete endotraqueal. Intervenção educacional. Equipe multiprofissional. A B S T R A C TThe invasive mechanical ventilation support promotes clear benefits. However, procedures involved in its institution can generate lesions in varying degrees. The cuff pressure surrounding the tracheal tube prevents air leakage and should not exceed tracheal perfusion pressure and should not be reduced also, allowing the passage of

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Laryngospasm

Abstract: The literature has several recommendations on the treatment or prevention of laryngospasm, but none of them is completely effective. Due to its severity, further studies on measures to prevent this complication are necessary.

Cited by 14 publications

References 54 publications

Postoperative negative pressure pulmonary edema following repetitive laryngospasm even after reversal of neuromuscular blockade by sugammadex: a case report

Postoperative negative pressure pulmonary edema following repetitive laryngospasm even after reversal of neuromuscular blockade by sugammadex: a case report

Effect of intravenous lidocaine on the incidence of postextubation laryngospasm: A double-blind, placebo-controlled randomized trial

Intervenção educacional relacionada à rotina de mensuração do balonete endotraqueal em um hospital universitário

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