Is there a role of a small dose of propofol in the treatment of laryngeal spasm?
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 trade mark ) 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.
D000768:Anesthesia, General; D002648:Child; D002675:Child, Preschool; D006801:Humans; D017214:Laryngeal Masks / Q000009:adverse effects*; D007826:Laryngismus / Q000188:drug therapy* / Q000209:etiology / Q000628:therapy; D010102:Oxygen Inhalation Therapy; D011175:Positive-Pressure Respiration; D015742:Propofol / Q000008:administration & dosage*
D015742:Propofol