One of the more frightening events in anesthesia is laryngospasm – the protective, reflex, spasmodic closure of the vocal cords that occurs when the vocal cords are stimulated. When laryngospasm occurs, vocal cord closure can be so forceful that it can prevent all ventilation or even the passage of the endotracheal tube. Life-threatening hypoxia can quickly follow. Other potential complications include post obstructive pulmonary edema, and possibly even cardiac arrest. This post discusses the different muscle actions that combine to make laryngospasm create dangerous airway obstruction.
The longer I do anesthesia, the more I realize that not knowing the details about the surgeries that I see every day can cause unexpected problems with the anesthesia. Removal of the hyoid as part of a thyroglossal duct cyst excision, normally innocuous, can rarely cause severe postoperative airway obstruction.
The need to change a tank in the middle of the case can happen anywhere to anyone. But if you´re prepared, it will go smoothly and your patient will remain safe.
The LMA provides an alternate means to ventilate a patient during surgery — without intubation and while freeing the provider’s hands from having to hold the mask. It provides a more secure airway that makes gastric distention less likely. Since its invention, the LMA has since become quite valuable as a rescue device in situations when intubation may be difficult — even for the inexperienced. Let’s talk about some tips for successful insertion.