Laryngospasm

Editor-in-Chief: Santosh Patel M.D., FRCA [mailto:santosh.patel@pat.nhs.uk]

Overview
In medicine, laryngospasm is an uncontrolled/involuntary muscular contraction (spasm) of the laryngeal cords. The condition typically lasts less than 30 or 60 seconds, and causes a partial blocking of breathing in, while breathing out remains easier. It may be triggered when the vocal cords or the area of the trachea below the cords detects the entry of water, mucus, blood, or other substance. It is characterized by stridor and or retractions. Some people suffer from frequent laryngospasms, whether awake or asleep. In an ear, nose and throat practice, it is typically seen in people who have silent reflux disease. It is also a well known, infrequent, but serious post-surgery complication.

Etiology
It is a complication associated with anesthesia. The spasm can happen often without any provocation, but tends to occur after tracheal extubation.

Treatment
Laryngospasm in the operating room is treated by hyperextending the patient's neck and administering assisted ventilation with 100% oxygen. In more serious cases it may require the administration of an intravenous muscle relaxant and reintubation.

In ear, nose and throat practices, it is treated by examining the patient in the office and reassuring the patient that laryngospasm resolves. Sometimes reflux medication is used to reduce the acidity in the stomach.