In this case series, we evaluated the incidence of laryngospasm using a clearly defined awake tracheal extubation technique in 20 children undergoing elective tonsillectomy with or without adenoidectomy. This technique required patients to be turned to the recovery position at the end of the procedure before discontinuing the volatile anesthetics. No further stimulation, besides continuous oximetry monitoring, was allowed until the patients spontaneously woke up (“no touch” technique). The incidence of laryngospasm, oxygen saturation, and coughing was recorded. No cases of laryngospasm, oxygen desaturation, or severe coughing occurred in our patient population.
IMPLICATIONS: This study re-emphasizes the importance of a sound anesthetic technique in tracheally extubating pediatric patients.
*Department of Anesthesiology and Pain Medicine and
†Department of Surgery, University of Alberta Hospitals, Edmonton, Canada
Supported, in part, by the Education and Research Fund, Department of Anesthesiology and Pain Medicine, University of Alberta Hospitals, Edmonton, Canada, and Clinical Investigatorship Award, Alberta Heritage Foundation for Medical Research, Alberta, Canada.
Accepted for publication September 8, 2003.
Address correspondence and reprint requests to Ban C.H. Tsui, MSC, MD, FRCP(C), Department of Anesthesiology and Pain Medicine, University of Alberta Hospitals, 3B2.32 Walter Mackenzie Health Science Centre, 8440-112 Street, Edmonton, Alberta, Canada T6G 2B7. Address e-mail to firstname.lastname@example.org.