Intraoperative laryngospasm occurs in <1% of cases. Recurrent laryngospasm is rarer. Some risk factors include shared airway and pediatric surgery, secretions, pungent volatile anesthetics, and patient factors, such as smoking and asthma. Conventional management includes the application of positive airway pressure, jaw thrust, the removal of any offending stimuli, deepening anesthesia, or administering muscle relaxants. Nebulized lidocaine is used to anesthetize the vocal cords before awake fiberoptic intubation. This case highlights the novel use of nebulized lidocaine to successfully treat refractory postoperative laryngospasm in a fully conscious adult patient after conventional measures were unsuccessful.
From the *Guy’s & St Thomas’ National Health Service Foundation Trust, London, United Kingdom
†Ysbyty Wrexham Maelor Hospital, Wrexham, Wales.
Accepted for publication December 26, 2018.
The authors declare no conflicts of interest.
The use of nebulized lidocaine for the management of laryngospasm is not Food and Drug Administration approved and is off-label.
Address correspondence to Zhihao Oon, FFPMRCA, FRCA, MBBS, BSc(Hons), 61 Basin Approach, London E14 7JA, United Kingdom. Address e-mail to firstname.lastname@example.org.