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Is there a role of a small dose of propofol in the treatment of laryngeal spasm?
Author(s) -
Afshan Gauhar,
Chohan Ursula,
QamarUlHoda Mohammad,
Kamal Rehana S.
Publication year - 2002
Publication title -
pediatric anesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.704
H-Index - 82
eISSN - 1460-9592
pISSN - 1155-5645
DOI - 10.1046/j.1460-9592.2002.00937.x
Subject(s) - medicine , propofol , anesthesia , laryngeal mask airway , intubation , ventilation (architecture) , surgery , tracheal intubation , body weight , airway , larynx , general anaesthesia , mechanical engineering , engineering
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% O 2 , with gentle positive pressure ventilation. Out of 20 patients, seven responded well with 100% O 2 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.