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Florida Society of Anesthesiologists

Patient Centered, Physician Driven

2019 FSA Posters

P055: DON’T SPEAK, I KNOW JUST WHAT YOU’RE THINKING: A LITERATURE REVIEW OF THE RESPONSE TO LARYNGOSPASM IN PEDIATRIC AND ADULT PATIENTS
Adam L Chadwick, MD, Sonia Mehta, MD, Joseph Lagrew, MD; University of Florida

Background: Laryngospasm is an airway emergency, and it is among the most feared complications encountered by anesthesia providers. Laryngospasm has an estimated incidence of 0.78% and is found in higher proportions in the pediatric population. Certain surgery types and medical comorbidities can further increase a patient’s likelihood of experiencing laryngospasm. An organized response can minimize poor outcomes and improve confidence in treating laryngospasm.

Methods: A systematic literature review using the electronic database, PubMed, was performed for publications from 1980 to 2018. Search terms used were: laryngospasm/laryngospasm response/laryngospasm treatment/laryngospasm pediatric/laryngospasm adult

Results: An initial search using the search term laryngospasm response produced 121 articles from 1981 to 2018. After the results were filtered to pediatric and adult populations, 69 articles remained. This review focused on articles directly addressing the response and/or treatment of laryngospasm in adult and/or pediatric patients, and 9 articles were found to meet these criteria. After review, it was found that an organized response to laryngospasm could be followed for adult and pediatric populations. The responses found in these articles included airway manipulation, patient positioning, positive airway pressure and pharmaceutical treatments. These responses, when organized in a stepwise fashion, provide an organized approach to the treatment of laryngospasm.

Conclusions: Laryngospasm is an airway emergency in adult and pediatric populations and can cause anxiety for the anesthesia provider. During this review, we identified and organized a step-by-step response to the treatment of laryngospasm in these patients using simple illustrations and outlines. It is our hope that this algorithm will alleviate anxiety and promote confidence in the anesthesia provider responding to laryngospasm and improve patient care and outcomes.

References:

  • Hampson-Evans DA, Morgan P, Farrar M. Pediatric laryngospasm. Pediatric Anesthesia. 2008 Apr 1;18(4):303-7.
  • Larson P.  Laryngospasm – the best treatment.  Anesthesiology.  1998;89:1293-1294
  • Johnstone RE. Laryngospasm treatment – an explanation. Anesthesiology 1999; 91: 581–582.