Abstract
Background: Several investigators have studied and made recommendations on literatures to reduce the incidence of laryngospasm during anesthesia. Contrastingly it is more frequently happening incident in pediatrics patient and brings a great challenge to anesthesia providers. Objective: The aim of this study was to identify the magnitude and risk factors associated with perioperative pediatrics laryngospasm and intervention strategies undertaken. Methodology: Hospital based cross sectional study was conducted on elective pediatrics patients (n=187) operated in Jimma University Teaching Hospital from February 1, 2015 to June 30, 2015. Result: Of the 53 (28.3%) laryngospasm events identified as cases, 30 (56.6%) occurred during induction, 4 (7.6%) during maintenance and 19 (35.8%) during emergence. 41 (77%) and 12 (23%) events were occurred during perioperative period on the hands of BSC and MSC anesthesia providers respectively. About 62.3% were precipitated by direct airway stimulations. Desaturation occurred in 42 (79.2%) of cases, bradycardia in 37 (69.2%), and cardiac arrest in 3 (5.7%) and there was death in 1.9% of case. There is a strong statistical associations between status of the providers with the incident of laryngospasm (P value is 0.01852356). 35 (66%) of cases were managed by removing the offending stimulus and administration of 100% oxygen with continuous positive pressure and in the absence of response 15 (28.3%) cases were treated with intravenous succinylcholine (0.25 to 1 mg x kg). 3 (5.7%) of children required cardiopulmonary resuscitation. There was no correlation across types of airway management devices utilized with the occurrence of laryngospasm (OR=0.6889, 95% C.I. 0358-1.3257, P=0.263552). Conclusions: Incidences of laryngospasm and its adverse events at pediatrics age group anaesthetized by junior anesthesia providers were high. Patient with upper respiratory tract infection and operated under general anesthesia with ETT were significant factors
Highlights
IntroductionLaryngospasm is one of the complications seen in the perioperative period especially during induction of anesthesia or during emergence
Incidences of laryngospasm and its adverse events at pediatrics age group anaesthetized by junior anesthesia providers were high
Patient with upper respiratory tract infection and operated under general anesthesia with ETT were significant factors for the development of laryngospasm leading to the occurrence of perioperative hemodynamic instability
Summary
Laryngospasm is one of the complications seen in the perioperative period especially during induction of anesthesia or during emergence. It consists of prolonged glottis closure reflex mediated by the superior laryngeal nerve [1]. Other common triggering factors are painful stimulation and insufficient depth of anesthesia on endotracheal intubation, light anesthesia on tracheal extubation with or without some irritant factors such as blood, mucus, and airway manipulations with laryngoscope blade, suction catheter, surgical debris or other foreign body [1]. Several investigators have studied and made recommendations on literatures to reduce the incidence of laryngospasm during anesthesia. It is more frequently happening incident in pediatrics patient and brings a great challenge to anesthesia providers
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