Abstract:
Introduction. Laryngospasm is a glottis closure due to reflex constriction of the laryngeal muscles. It can occur at any phase of the
anesthetic. Different studies have been done previously with various results and indicative values which initiated us to do this research.
,is study aimed to assess the incidence and associated factors of laryngospasm among pediatric patients who underwent surgery
under general anesthesia (GA). Methods. Institution-based, cross-sectional study was conducted on pediatric patients from February to
August, 2019, in University of Gondar Comprehensive Specialized Hospital (UOGCSH). Data were entered and analyzed with SPSS
version 20. Variables with P value less than <0.2 in bivariate analysis were fitted into the multivariable logistic regression analysis to
identify factors associated with laryngospasm. Both crude and adjusted odds ratio with 95% CI were calculated to show strength of
association. In multivariable analysis, P value of<0.05 was considered as statistically significant. Results. ,e incidence of laryngospasm
among pediatric patients who underwent surgery under GA was 57 (18.4%). Of this, 34 (59.6%), 12 (21.1%), and 11 (19.3%) happened
during emergence, maintenance, and induction phases of GA, respectively. In multivariable analysis, airway anomalies (AOR: 14.64,
95% CI: 1.71, 125.04), secretion (AOR: 2.45, 95% CI: 1.19, 5.06), attempts of airway devices (AOR: 2.47, 95% CI: 1.16, 5.22), upper
respiratory tract infection (AOR: 2.91, 95% CI: 1.008, 8.41), and inadequate depth of anesthesia (AOR: 7.92, 95% CI: 2.7, 23.22) were
significantly associated with incidence of laryngospasm. Conclusions. Laryngospasm can occur at any phase of the anesthetic. At
UOGCSH, the overall rate of laryngospasm was 18.4%, with the vast majority of episodes occurring on emergence. Inadequate depth of
anesthesia, URTI, airway anomalies, multiple attempts of airway devices, and oropharyngeal secretion were predictors of laryngospasm. So, added vigilance is needed in patients with URTI, airway anomalies, or those who require multiple attempts at airway
device insertion. Prompt clearing of airway secretions and adequate depth of anesthesia may help to prevent laryngospasm. Since the
majority of our patients received an IV induction, endotracheal intubation, and maintenance with halothane, caution must be taken in
extrapolating these results to other patient populations.
1. Introduction
Pediatric laryngospasm is defined as glottis closure due to
reflex constriction of the laryngeal muscles that produce
partial or complete obstruction of the larynx. When complete and sustained, laryngospasm can become an anesthetic
emergency. It mainly happens at induction, maintenance,
and emergence phases of GA [1]. Laryngospasm usually
manifests with the sign of inspiratory stridor which
