P028: TRANSNASAL HUMIDIFIED RAPID-INSUFFLATION VENTILATORY EXCHANGE: A NOVEL APPROACH IN MANAGEMENT OF REFRACTORY LARYNGOSPASM
Anwar Mack, MD, Klaus Torp, MD, Elird Bojaxhi, MD; Mayo Clinic
We present a 49-year-old female undergoing dilation of subglottic stenosis who experienced refractory laryngospasm upon emergence. Four episodes of laryngospasm were transiently managed with intravenous boluses of 20mg succinylcholine, 30mg propofol and 20 cmH20 of positive pressure ventilation with jaw-thrust. Patient’s oxygenation ultimately improved with administration of THRIVE and 40% FiO2. Thrive was continued in the PACU, racemic epinephrine was administered for stridor. Patient’s symptoms resolved in the PACU and patient was discharged home. This novel use of THRIVE has yet to be reported in anesthesia literature and may be a viable option for patients experiencing refractory laryngospasm.