Old Laryngospasm Complication: New Treatments

Laryngospasm (LEP) is defined as the sustained closure of the vocal cords. It is a primitive protective airway reflex (VA), which occurs to safeguard the integrity of the airway by protecting it from tracheobronchial aspiration [1]. LEP is also defined as an exaggerated response to closure reflex or glottic muscle spasm. Essentially it is a protective reflex, which acts to prevent the entry of any foreign material into the tracheobronchial tree. The presence of this reflex results in an impediment to adequate breathing, under these conditions it becomes a sudden obstruction of upper VA. A feature of LEP is that VA closure is maintained even after the initial causal stimulus disappears. In any of the situations mentioned above, we face a partial or total loss of VA, and therefore an anesthetic urgency. 40% of VA obstructions are secondary to LEP, may result in a lifethreatening complication, and is a major cause of cardiac arrest in the pediatric patient.