Management of Refractory Laryngospasm

Amy L. Rutt, Elird Bojaxhi, Klaus D. Torp

Research output: Contribution to journalArticle

Abstract

Laryngospasm has been well described in patients emerging from general anesthesia (GA) and is routinely managed with intermittent positive-pressure mask ventilation, a temporary increase in the depth of anesthesia, or small, titrated amounts of succinylcholine. Patients with severe laryngospasm require reintubation to maintain adequate oxygenation and ventilation. However, reintubation may be only a temporary solution because laryngospasm may recur during re-emergence and re-extubation; thus, anesthesiologists need a comprehensive plan that addresses potential causes of laryngospasm and incorporates continuous positive airway pressure (CPAP) for patients with difficulty emerging from GA. Transnasal humidified rapid-insufflation ventilatory exchange (THRIVE) is a noninvasive ventilation and oxygenation technique used to provide apneic oxygenation, which also generates CPAP. THRIVE uses a high-flow nasal cannula and is more easily tolerated than CPAP with a tight-fitting mask. To our knowledge, we present the first case of refractory laryngospasm during emergence from GA that was successfully managed with THRIVE.

Original languageEnglish (US)
JournalJournal of Voice
DOIs
StateAccepted/In press - Jan 1 2020

Keywords

  • Airway
  • General anesthesia
  • High-flow nasal cannula
  • Laryngospasm
  • Oxygenation
  • Transnasal humidified rapid-insufflation ventilatory exchange

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Speech and Hearing
  • LPN and LVN

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  • Cite this

    Rutt, A. L., Bojaxhi, E., & Torp, K. D. (Accepted/In press). Management of Refractory Laryngospasm. Journal of Voice. https://doi.org/10.1016/j.jvoice.2020.01.004