Prevention and management of laryngospasm

Pediatric laryngospasm

Pediatric laryngospasm is an anesthetic emergency. It is a relatively common phenomenon that occurs with varying frequency dependent on multiple factors. In view of this and the clear risks to the patient when it occurs, a consensus committee has been established to determine the evidence based management of this condition. This article will cover the definition, causes and recognition of laryngospasm and the evidence behind a proposed algorithm for its' management.

Multiple system atrophy as a cause of upper airway obstruction

A patient presented to the ear, nose and throat department with inspiratory stridor, dysphagia and a sore throat. Clinical and radiological examination was normal. During induction of anaesthesia for a planned microlaryngoscopy, the patient developed complete upper airway obstruction that was overcome by applying positive pressure via a facepiece until awake. He subsequently developed respiratory failure, requiring mechanical ventilatory support. An elective tracheostomy was inserted for his symptoms. Neurological opinion confirmed the diagnosis of multiple system atrophy with akinetic rigid syndrome. We review this obscure condition and how it may occasionally present to anaesthetists.