title: Laryngospasm With Apparent Aspiration During Sedation With Nitrous Oxide.
abstract: Nitrous oxide and oxygen mixture has become increasingly popular for the procedural sedation and analgesia of children in the emergency department. In general, nitrous oxide is regarded as a very safe agent according to large case series. We report a case of single-agent nitrous oxide sedation of a child, complicated by laryngospasm and radiographically confirmed bilateral upper lobe pulmonary opacities. Although rarely reported with parenteral sedative agents, laryngospasm and apparent aspiration has not been previously reported in isolated nitrous oxide sedation. This case highlights that, similar to other sedative agents, nitrous oxide administration also needs to be conducted by staff and in settings in which airway emergencies can be appropriately managed.
authors.affiliation: Murdoch Children's Research Institute and the Emergency Department, Royal Children's Hospital Melbourne, Melbourne, Victoria, Australia; Department of Pediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia. Electronic address: franz.babl@rch.org.au.
authors.forename: Franz E
authors.initials: FE
authors.lastname: Babl
authors.affiliation: Murdoch Children's Research Institute and the Emergency Department, Royal Children's Hospital Melbourne, Melbourne, Victoria, Australia; Department of Pediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Joanne
authors.initials: J
authors.lastname: Grindlay
authors.affiliation: Murdoch Children's Research Institute and the Emergency Department, Royal Children's Hospital Melbourne, Melbourne, Victoria, Australia; Paediatric Emergency Research Unit, National Children's Research Centre, Dublin, Ireland.
authors.forename: Michael Joseph
authors.initials: MJ
authors.lastname: Barrett
mesh_terms: D000293:Adolescent; D016292:Procedural Sedation / Q000009:adverse effects*; D004636:Emergency Service, Hospital; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage* / Q000009:adverse effects; D007826:Laryngismus / Q000209:etiology*; D008297:Male; D009609:Nitrous Oxide / Q000008:administration & dosage* / Q000009:adverse effects; D053120:Respiratory Aspiration / Q000209:etiology*
chemical_list: D006993:Hypnotics and Sedatives; D009609:Nitrous Oxide