Using "Laryngospasm Notch".
Laryngospasm is a potentially life-threatening condition that can be managed through expeditious use of sedation, neuromuscular blockers, and airway maneuvers. Patients at high risk for this complication can be identified and measures taken to prepare for this complication.
Some anesthesiologists recommend the application of firm pressure to the “laryngospasm notch” (Figure) bilaterally while performing the jaw thrust. Superior laryngeal nerve block can be considered if all other measures fail.
In addition to performance of a jaw thrust maneuver, the level of anesthesia (or sedation) should be deepened with an inhaled anesthetic or intravenous propofol (0.25-1.0 mg/kg). If laryngospasm persists, administration of a relatively small dose of succinylcholine is indicated (0.1-0.25 mg/kg intravenously or 4 mg/kg intramuscularly if intravenous access is not available). Atropine (0.02 mg/kg) should be administered concomitantly because succinylcholine may be associated with severe bradycardia, especially in the presence of hypoxemia. Tracheal intubation may or may not be required. Lidocaine 4% can also be administered topically to the larynx to help abort the spasm.
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