Disease relevance of Laryngismus

• Acute systemic reactions, characterized by hypotension, mucosal irritability, and laryngospasm requiring epinephrine, diphenhydramine, and/or methylprednisolone treatment, occurred sporadically in three adults and one child, treated for both luminal and fistulizing disease [1].
• Coughing, movement, laryngospasm and sinus tachycardia occurred more frequently with isoflurane [2].
• Spontaneous movements and pain on injection were seen significantly more frequently with propofol, whereas laryngospasm and hiccup were only observed with thiopental [3].
• Primary laryngospasm in a patient with Parkinson's disease: treatment with CPAP via minitracheostomy following intubation [4].
• Minor complications occurred during 39 studies: transient laryngospasm in 1, unintended delivery of an ICD shock to a conscious patient in 4; induction of sustained atrial fibrillation in 8; need for external rescue defibrillation shocks in 13; and delivery of inappropriate shocks for supraventricular rhythms in 14 studies [5].

High impact information on Laryngismus

• Four patients had laryngospasm and four had jaw opening dystonia (two with neck dystonia) [6].
• Allergic laryngospasm on initiating oral propranolol therapy [7].
• Sevoflurane is well tolerated by adult and paediatric patients during induction of anaesthesia, with a low incidence of mild airway complications (breath-holding, coughing, excitement and laryngospasm) [8].
• Intramuscular succinylcholine and laryngospasm [9].
• The authors speculate that the onset of intramuscular mivacurium is too slow to treat laryngospasm or to facilitate routine tracheal intubation in infants or children, despite administration of large doses [10].

Chemical compound and disease context of Laryngismus

• Lidocaine caused a constriction of the larynx and LR greatly increased, leading frequently to laryngospasm [11].
• In contrast, laryngospasm and coughing were rare during induction of anesthesia with halothane [12].
• Neither dose of ketamine increased the incidence of laryngospasm, prolonged recovery times, or caused emergence phenomena [13].
• Moderate-to-severe laryngospasm (49%) and moderate-to-severe coughing (58%) occurred frequently during induction of anesthesia with desflurane; the incidence of these was not altered by premedication [12].
• Propofol for relief of extubation laryngospasm [14].

Biological context of Laryngismus

• The incidences of aspiration, regurgitation, laryngospasm, wheezing, succinylcholine administration, oxygen saturation (SpO2) < 92%, failed use, and minor intraoperative problems were similar [15].
• To our knowledge, this is the first report of paradoxical bronchoconstriction and laryngospasm due to repeated doses of beta 2-agonist solutions with edetate disodium [16].
• Compared with halothane, isoflurane resulted in prolonged induction times and inferior induction scores due to increased salivation, coughing, breathholding and laryngospasm [17].
• A 5-year experience with ketamine sedation for pediatric gastroenterology procedures was reviewed to document the safety profile of this agent and to identify predictors of laryngospasm during esophagogastroduodenoscopy (EGD) [18].
• Gagging, laryngospasm and head movement were more common using thiopentone (P < 0.01, P < 0.05 and P < 0.05 respectively) and in 11% (P < 0.05) of the thiopentone group insertion of the LMA was impossible due to inadequate relaxation [19].

Gene context of Laryngismus

• Paroxysmal laryngospasm secondary to gastroesophageal reflux [20].
• Laryngospasm, as an isolated symptom of epilepsy, is a rare phenomenon [1, 3, 5] [21].
• Recurrent laryngospasm: a neglected symptom of hypoparathyroidism [22].

Analytical, diagnostic and therapeutic context of Laryngismus

• The group receiving topical lignocaine had a lower incidence of laryngospasm (p < 0.05), required fewer attempts for successful insertion of the laryngeal mask (p < 0.05) and coughed or gagged less frequently than either group receiving lignocaine intravenously (p > 0.05) [23].
• Propofol relieves post-extubation laryngospasm in obstetric anesthesia [24].
• Continuous positive airway pressure as a promoter of laryngospasm during halothane anesthesia [25].
• CONCLUSIONS: During emergence from inhalational anesthesia, propofol in a subhypnotic dose (0.5 mg.kg(-1)) decreases the likelihood of laryngospasm upon tracheal extubation in children undergoing tonsillectomy with or without adenoidectomy [26].

References