Risk factors for laryngospasm in children during general anesthesia

Randall Flick, Robert T. Wilder, Stephen F. Pieper, Kevin Vankoeverden, Kyle M. Ellison, M. E S Marienau, Andrew C. Hanson, Darrell R. Schroeder, Juraj Sprung

Research output: Contribution to journalArticle

63 Citations (Scopus)

Abstract

Background: Laryngospasm is a common and often serious adverse respiratory event encountered during anesthetic care of children. We examined, in a case control design, the risk factors for laryngospasm in children. Material and Methods: The records of 130 children identified as having experienced laryngospasm under general anesthesia were examined. Cases were identified from those prospectively entered into the Mayo Clinic performance improvement database between January 1, 1996 and December 31, 2005. Potential demographic, patient, surgical and anesthetic related risk factors were determined in a 1 : 2 case-control study. Results: No individual demographic factors were found to be significantly associated with risk for laryngospasm. However, multivariate analysis demonstrated significant associations between laryngospasm and intercurrent upper respiratory infection (OR 2.03 P = 0.022) and the presence of an airway anomaly (OR = 3.35, P = 0.030). Among those experiencing laryngospasm during maintenance or emergence, the use of a laryngeal mask airway was strongly associated even when adjusted for the presence of upper respiratory infection and airway anomaly (P = 0.019). Ten patients experienced postoperatively one or more complications whereas only three complications were observed among controls (P = 0.008). No child required cardiopulmonary resuscitation and there were no deaths in either study cohort. Conclusions: In our pediatric population, the risk of laryngospasm was increased in children with upper respiratory tract infection or an airway anomaly. The use of laryngeal mask airway was found to be associated with laryngospasm even when adjusted for the presence of upper respiratory tract infection and airway anomaly.

Original languageEnglish (US)
Pages (from-to)289-296
Number of pages8
JournalPaediatric Anaesthesia
Volume18
Issue number4
DOIs
StatePublished - Apr 2008
Externally publishedYes

Fingerprint

Laryngismus
General Anesthesia
Respiratory Tract Infections
Laryngeal Masks
Anesthetics
Demography
Cardiopulmonary Resuscitation
Child Care
Case-Control Studies
Cohort Studies
Multivariate Analysis
Maintenance
Databases
Pediatrics

Keywords

  • Children
  • Endotracheal tube
  • General anesthesia
  • Laryngeal mask
  • Laryngospasm
  • Mask

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine
  • Pediatrics, Perinatology, and Child Health

Cite this

Flick, R., Wilder, R. T., Pieper, S. F., Vankoeverden, K., Ellison, K. M., Marienau, M. E. S., ... Sprung, J. (2008). Risk factors for laryngospasm in children during general anesthesia. Paediatric Anaesthesia, 18(4), 289-296. https://doi.org/10.1111/j.1460-9592.2008.02447.x

Risk factors for laryngospasm in children during general anesthesia. / Flick, Randall; Wilder, Robert T.; Pieper, Stephen F.; Vankoeverden, Kevin; Ellison, Kyle M.; Marienau, M. E S; Hanson, Andrew C.; Schroeder, Darrell R.; Sprung, Juraj.

In: Paediatric Anaesthesia, Vol. 18, No. 4, 04.2008, p. 289-296.

Research output: Contribution to journalArticle

Flick, R, Wilder, RT, Pieper, SF, Vankoeverden, K, Ellison, KM, Marienau, MES, Hanson, AC, Schroeder, DR & Sprung, J 2008, 'Risk factors for laryngospasm in children during general anesthesia', Paediatric Anaesthesia, vol. 18, no. 4, pp. 289-296. https://doi.org/10.1111/j.1460-9592.2008.02447.x
Flick R, Wilder RT, Pieper SF, Vankoeverden K, Ellison KM, Marienau MES et al. Risk factors for laryngospasm in children during general anesthesia. Paediatric Anaesthesia. 2008 Apr;18(4):289-296. https://doi.org/10.1111/j.1460-9592.2008.02447.x
Flick, Randall ; Wilder, Robert T. ; Pieper, Stephen F. ; Vankoeverden, Kevin ; Ellison, Kyle M. ; Marienau, M. E S ; Hanson, Andrew C. ; Schroeder, Darrell R. ; Sprung, Juraj. / Risk factors for laryngospasm in children during general anesthesia. In: Paediatric Anaesthesia. 2008 ; Vol. 18, No. 4. pp. 289-296.
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