Is there a role of a small dose of propofol in the treatment of laryngeal spasm?

Authors: Afshan G.; Chohan U.; Qamar-Ul-Hoda M.; Kamal R.S.

Source: Paediatric Anaesthesia, Volume 12, Number 7, September 2002 , pp. 625-628(4)

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Abstract:

Summary

Background: Propofol has been found to depress the laryngeal reflexes. We studied whether this property could be utilized to relieve laryngeal spasm.

Methods: This study was conducted over a period of 3 years, and included children aged 3–10 years, ASA status I and II. Most of the children were undergoing minor surgical procedures, under general anaesthesia with Laryngeal Mask Airway (LMA™) and caudal epidural analgesia.

Results: During this period, 20 patients developed laryngeal spasm on removal of the LMA at the end of surgery. Initially, they all were treated with 100% O₂, with gentle positive pressure ventilation. Out of 20 patients, seven responded well with 100% O₂ and gentle positive pressure ventilation. The remaining 13 were treated with a small dose of propofol (0.8 mg·kg^-1 body weight). Laryngeal spasm was relieved successfully in 10 patients and three patients required intubation to improve their oxygenation.

Conclusions: Propofol in a small dose (0.8 mg·kg^-1 body weight) was a useful drug to relieve laryngeal spasm in most children (76.9%) following the removal of the LMA. Because it was not found to be effective in all patients, succinylcholine still has a role to play in critical conditions. However, we recommend propofol as a suitable alternative for relieving laryngeal spasm in situations where succinylcholine is contraindicated.

Keywords: LMA; laryngeal spasm; paediatrics; propofol; succinylcholine

Document Type: Research article

DOI: http://dx.doi.org/10.1046/j.1460-9592.2002.00937.x

Affiliations: 1: Department of Anaesthesia, The Aga Khan University Hospital (AKUH), Karachi, Pakistan

Publication date: 2002-09-01