Laryngismus (Laryngospasm)

A disorder in which the adductor muscles of the VOCAL CORDS exhibit increased activity leading to laryngeal spasm. Laryngismus causes closure of the VOCAL FOLDS and airflow obstruction during inspiration.

Also Known As:

Networked: 393 relevant articles (21 outcomes, 25 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Bronchial Spasm
2.	Respiratory Sounds (Crackle)
3.	Cleft Palate (Palate, Cleft)
4.	Vomiting
5.	Cough

Experts

1.	von Ungern-Sternberg, Britta S: 5 articles (04/2012 - 12/2005)
2.	Erb, Thomas O: 4 articles (04/2012 - 12/2005)
3.	Elwood, Tom: 4 articles (02/2007 - 03/2003)
4.	Krauss, Baruch: 3 articles (11/2010 - 04/2006)
5.	von Ungern-Sternberg, B S: 2 articles (04/2015 - 01/2013)
6.	Simon, Ronald A: 2 articles (03/2015 - 08/2010)
7.	Gibson, Charles: 2 articles (10/2014 - 10/2004)
8.	Schwartz, Donald: 2 articles (10/2014 - 10/2004)
9.	Goudra, Basavana Gouda: 2 articles (01/2014 - 07/2013)
10.	Sinha, Ashish C: 2 articles (01/2014 - 07/2013)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Laryngismus:

1.	Lidocaine (Xylocaine)FDA LinkGeneric 12/01/2014 - "We conclude that, both topical and intravenous lidocaine are effective for preventing laryngospasm in children. " 12/01/2014 - "Subgroup analysis revealed that both intravenous lidocaine (RR 0.34, 95% CI 0.14-0.82) and topical lidocaine (RR 0.42, 95% CI 0.22-0.80) lidocaine are effective in preventing laryngospasm. " 12/01/2014 - "The combined results demonstrated that lidocaine is effective in preventing laryngospasm (risk ratio (RR) 0.39, 95% CI 0.24-0.66; I(2)  = 0). " 12/01/2014 - "The purpose of this meta-analysis was to determine the efficacy of lidocaine in preventing laryngospasm during general anaesthesia in children. " 12/01/2014 - "The efficacy of lidocaine to prevent laryngospasm in children: a systematic review and meta-analysis."
2.	KetamineFDA LinkGeneric 12/01/2007 - "This study indicates that the 3 regimens are associated with acceptable induction characteristics, but administration of ketamine intravenously is superior to its administration intramuscularly and laryngeal desensitisation is recommended to avoid laryngospasms." 01/01/2011 - "A pilot trial of ketamine at our institution was associated with episodes of laryngospasm. " 11/01/2010 - "The objective of this study was to assess predictors of emergency department (ED) ketamine-associated laryngospasm using case-control techniques. " 10/01/2013 - "Knowledge gaps exist among PHs regarding contraindications for ketamine and N2O that are infrequently encountered in patients and for the management of laryngospasm, a rare adverse event with ketamine. " 01/01/2011 - "There were 2 episodes of laryngospasm during ketamine sedation. "
3.	OxygenIBA 09/01/1998 - "As judged by an increase in peripheral oxygen saturation, the laryngospasm was relieved within 1 min of acupuncture in all patients. " 07/01/2014 - "Unexpectedly, during waking up from anaesthesia the patient became dyspnoeic, laryngospasm appeared, the oxygen saturation dropped again, strong facial and tongue oedema appeared and an urgent reintubation had to be performed. " 11/01/2011 - "Age <2 years (p<0.01), AHI >24 (p<0.05), intra-operative laryngospasm requiring treatment (p<0.05), oxygen saturations <90% on room air in PACU (p<0.05) and PACU stay >100 min (p<0.01) independently predicted post-operative complications. " 12/01/2010 - "Gentle chest compression with 100% oxygen is a simple and effective technique for immediate management of post extubation laryngeal spasm in children." 03/01/2010 - "Following extubation for 10 minutes, the haemodynamic parameters, that is, pulse, blood pressure, oxygen saturation, severity of coughing, and laryngospasm were noted. "
4.	Propofol (Diprivan)FDA LinkGeneric 12/01/2005 - "In this study, we sought to assess whether the empiric use of a subhypnotic dose of propofol prior to emergence will decrease the occurrence of laryngospasm following extubation in children. " 12/01/2007 - "Laryngospasms occurred in 2 cats that received propofol. " 12/01/2005 - "Laryngospasm was seen in 20% (n = 12) of the 60 children in the control group and in only 6.6% (n = 4) of 60 children in the propofol group (P < 0.05). " 06/01/2003 - "Propofol has been used with some success in treating postoperative laryngospasm and for tracheal intubation without muscle relaxants. " 10/01/2002 - "Propofol for relief of extubation laryngospasm."
5.	Fentanyl (Sublimaze)FDA LinkGeneric 07/01/2010 - "The incidence of laryngospasm lasting for more than 10 s was 26% before receiving fentanyl, 31% after recieving1.5 microg/kg fentanyl, and 18% after receiving a second dose of 1.5 microg/kg fentanyl (P = 0.36 and 0.78, respectively). " 07/01/2010 - "The incidence of laryngospasm was not reduced when up to two successive doses of 1.5 microg/kg fentanyl were administered. " 07/01/2010 - "The authors hypothesized that the incidence of laryngospasm evoked by laryngeal stimulation is reduced with increasing doses of fentanyl. " 05/01/2000 - "However, there was a difference in the incidence of adverse airway events (breath-holding, coughing and laryngospasm) between the two groups (16.5% in the fentanyl group and 40% in the placebo group); this did not reach statistical significance. " 03/01/2000 - "Fentanyl-induced chest wall rigidity and laryngospasm in preterm and term infants."
6.	Halothane (Fluothane)FDA Link 01/01/1998 - "The authors report a case of severe acute pulmonary oedema secondary to a laryngeal spasm in a 3-week-old neonate, immediately after induction of anaesthesia with halothane. " 01/01/1992 - "Peak inspiratory pressures--a measure of tight fitting of the mask--are shown in Table 2. Laryngospasm occurred in 2 children who had inhalation inductions with halothane. " 03/01/1992 - "In contrast, laryngospasm and coughing were rare during induction of anesthesia with halothane. " 11/01/1992 - "Continuous positive airway pressure as a promoter of laryngospasm during halothane anesthesia." 09/01/1979 - "Inhalational induction with halothane was used rountinely, with surprisingly few instances of laryngospasm or upper airway obstruction. "
7.	Midazolam (Versed)FDA LinkGeneric 08/01/1998 - "Laryngospasm is listed by the manufacturer as a rare side effect of midazolam. " 01/01/2008 - "Careful titration of ketamine and low-dose midazolam provides adequate sedation for nonsurgical pediatric short-term procedures also requiring considerable pharyngeal manipulation, particularly considering the low number of serious airway problems such as laryngospasm. " 08/01/1998 - "Neither midazolam-induced laryngospasm nor its reversal with flumazenil have previously been reported. " 08/01/1998 - "Shortly after receiving midazolam, he developed laryngospasm and resultant respiratory distress; the laryngospasm was reversed by a small dose of flumazenil. " 08/01/1998 - "Reversal of midazolam-induced laryngospasm with flumazenil."
8.	Succinylcholine (Suxamethonium Chloride)FDA LinkGeneric 10/01/1997 - "Besides laryngospasm during anaesthetic induction, relieved by sublingual succinylcholine injection, the perianaesthetic course was uneventful. " 11/01/1990 - "This study was designed to determine if the injection of succinylcholine by an extraoral submental approach would be an acceptable method of terminating laryngospasm when compared to conventional intramuscular sites. " 07/01/2013 - "Intra-lingual succinylcholine for the treatment of adult laryngospasm in the absence of IV access." 04/01/2011 - "Intraoperative laryngospasm was treated with intravenous suxamethonium. " 06/01/2009 - "In no intravenous line situation, laryngospasm can be treated with succinylcholine administration by intramuscular, intraosseous and intralingual routes. "
9.	Omeprazole (Esomeprazole)FDA LinkGeneric 12/01/1996 - "This study documents the role of GER in the etiology of paroxysmal laryngospasm, it highlights the advantages of double-probe pH-metry in diagnosing this extraesophageal manifestation of GER, and it demonstrates that antireflux therapy with omeprazole is effective in controlling GER-induced laryngospasm."
10.	Epinephrine (Adrenaline)FDA LinkGeneric 02/01/2010 - "A 14-month-old child developed laryngospasm which recovered completely after hospital treatment with adrenaline. " 01/01/1990 - "During this procedure, she developed a generalized rash and laryngospasm; the use of adrenaline was required. " 03/01/2012 - "Adverse effects of immunotherapy include frequent local symptoms (16% of doses), mild laryngospasm [relative risk: 12.9 (1.7-98.6)], mild asthma [rate ratio: 3.8 (2.9-5.0)], reactions requiring oral glucocorticosteroids [relative risk: 11.3 (2.7-46.5)] or intramuscular epinephrine injection [rate ratio 5.8 (1.6-21.9)]. " 08/01/2006 - "To evaluate the efficacy of topical racemic adrenaline (RA) (Micronefrin; Bird Products, Palm Springs, CA, USA) in the control of intraoperative bleeding and the prevention of postoperative bleeding, laryngeal spasm and postoperative pain in adenoidectomy among children <6 years of age. " 03/01/1985 - "Immediate reversal of severe laryngospasm by intranasally instilled lidocaine with epinephrine."

Therapies and Procedures

1.	Adenoidectomy 02/01/2004 - "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. " 02/01/2004 - "The incidence of laryngospasm with a "no touch" extubation technique after tonsillectomy and adenoidectomy." 10/01/1991 - "Tonsillectomy and adenoidectomy can predispose to stridor and laryngospasm in the immediate postextubation period. " 06/01/1998 - "The most important complications from tonsillectomy and adenoidectomy are bleeding, stridor, and laryngospasm. " 09/01/2007 - "This unusual disease is actually attributed to pulmonary and hemodynamic changes engendered by high negative intrathoracic pressures during the state of obstructed respiration, such as laryngospasm, epiglottitis, laryngotracheal neoplasm, etc. In this article, we report three cases of negative pressure pulmonary edema (NPPE) developed after the operations of tracheotomy, adenoidectomy, and microlaryngeal surgery. "
2.	Anesthesia 07/01/2013 - "Clinical outcomes in pediatric anesthesia have improved significantly over the last 20-30 years but unexpected laryngospasm that is difficult to treat can still result in patient morbidity, increased postoperative medical management and unnecessary hospital admission. " 12/01/1998 - "During emergence from anesthesia, none of patients held their breath or experienced laryngospasm in the current study. " 04/01/2014 - "Regurgitant food particle causing intractable laryngospasm during emergence from anesthesia." 07/01/2013 - "Therefore, we applied quality improvement (QI) methodology to: (i) identify the etiology and contributing factors that lead to unanticipated incidents during pediatric anesthesia care; and (ii) decrease the incidence of laryngospasm during pediatric anesthesia care by focusing on awareness, preparedness, education and knowledge translation. " 07/01/2013 - "The incidence of laryngospasm in pediatric anesthesia is difficult to determine with incidences from 0.9% to as high as 14% quoted in the literature. "
3.	Tonsillectomy 02/01/2004 - "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. " 02/01/2004 - "The incidence of laryngospasm with a "no touch" extubation technique after tonsillectomy and adenoidectomy." 10/01/1991 - "Tonsillectomy and adenoidectomy can predispose to stridor and laryngospasm in the immediate postextubation period. " 01/01/2012 - "Tonsillectomy is one of the most common surgical operations and has such complications as pain, hemorrhage and laryngospasm. " 06/01/1998 - "The most important complications from tonsillectomy and adenoidectomy are bleeding, stridor, and laryngospasm. "
4.	Injections 05/01/2010 - "A total of 438 patients were diagnosed as having laryngeal spasm and chronic cough, and 6 were documented as having chronic cough treated with BtxA injections. " 04/01/1993 - "Local injections of botulinum toxin resulted in spectacular regression of laryngeal spasms and major improvement in breathing. " 07/01/2006 - "Repeated IV propofol injections (1 mg kg(-1) in 30 seconds) were given until LMA insertion or endotracheal intubation was achieved, when the presence or absence of laryngospasm, the respiratory rate (fr) and the total dose of propofol used were recorded. " 01/01/2005 - "Laryngospasm and bronchospasm following parecoxib injections."
5.	Hypnosis (Mesmerism) 10/01/2010 - "Complications such as pain on injection, dystonic movements, erythema, laryngeal spasm, episodes of desaturation, hypoventilation and the number of additional boluses required to induce hypnosis were also recorded. " 12/01/2005 - "The authors hypothesized that the incidence of apnea with laryngospasm evoked by laryngeal stimulation would not differ between sevoflurane and propofol when used in equipotent doses and that laryngeal responsiveness would be diminished with increased levels of hypnosis. " 12/01/2005 - "Apnea with laryngospasm occurred more often during anesthesia with sevoflurane compared with propofol independent of the level of hypnosis: episodes lasting longer than 5 s, 34% versus 19% at BIS 40 and 34% versus 16% at BIS 60; episodes lasting longer than 10 s, 26% versus 10% at BIS 40 and 26% versus 6% at BIS 60 (group differences P < 0.04 and P < 0.01, respectively). " 02/01/2015 - "The list of level A recommendations includes: 1) use of IV acetaminophen for opioid sparing properties and reduction of opioid related adverse events; 2) ketamine-midazolam combination preferred over fentanyl-midazolam fentanyl-propofol in pediatric patients; 3) boluses of ketamine IV (particularly in the population under the age of 2 years and over the age of 13) can lead to impairment of the upper airways, including the onset of laryngospasm, requiring specific expertise and skills for administration; 4) the use of ketamine increases the potential risk of psychomotor agitation, which can happen in up to 30% of adult patients (this peculiar side effect can be significantly reduced by concomitant systemic use of benzodiazepines); 5) for shoulder dislocations and fractures of the upper limbs, the performance of brachial plexus block reduces the time spent in ED compared to sedation; 6) pain relief and the use of opioids in patients with acute abdominal pain do not increase the risk of error in the diagnostic and therapeutic pathway in adults; 7) in newborns, the administration of sucrose reduces behavioural responses to blood sampling from a heel puncture; 8) in newborns, breastfeeding or formula feeding during the procedure reduces the measures of distress; 9) in pediatric patients, non-pharmacological techniques such as distraction, hypnosis and cognitive-behavioural interventions reduce procedural pain caused by the use of needles; 10) in pediatric patients, preventive application of eutectic mixtures of prilocaine and lidocaine allows arterial and venous samples to be taken in optimum conditions; 11) in pediatric patients, the combination of hypnotics (midazolam) and N2O is effective for procedural pain, but may be accompanied by loss of consciousness. "