Von ungern-Sternbergs results were similar to this study and revealed that there was no difference in overall incidence of perioperative adverse respiratory events including post-operative laryngospasm
after awake or deep extubation and that both techniques may be safely used provided proper precautionary measures are taken and anaesthesiologist is alert and vigilant18.
Grading of conditions for Laryngeal Mask Airway Insertion were Noted Introduction of the LMA 3 2 1 Jaw relaxation Full Partial Difficult ease of Insertion Easy Difficult Impossible Patient's Response 3 2 1 Coughing Nil Transient Persistent Biting Nil Transient Persistent Gagging Nil Transient Persistent Laryngospasm
Nil Partial Total Table 2 Propofol Sevoflurane N Mean SD N Mean SD Loss of verbal 25 57.40 15.01 25 65.40 9.67 eye contact Loss of eyelash reflex 25 73.00 13.92 25 81.20 9.39 Jaw relaxation 25 89.20 15.52 25 103.20 12.07 LMA insertion 25 100.80 14.48 25 122.00 15.61 P value Loss of verbal .030 eye contact Loss of eyelash reflex .018 Jaw relaxation 0.001 LMA insertion 0.0001 Table 3.
Adverse events such as bronchospasm, laryngospasm
, airway obstruction, oxygen desaturation and aspiration were not observed in any patient.
It would have been informative if apnea, airway obstruction, or increased airway reactivity associated with coughing, breath holding, and laryngospasm
were identified as the cause of the hypoxemic episodes.
After anesthesia induction, complications such as desaturation, laryngospasm
, increased secretions, cough, and breath holding were not observed in any case.
The medical records of the study subjects were used to record age, weight, comorbid conditions, duration of operation, premedication status, agents used for premedication, anesthesia induction, postoperative analgesia, number and type of LMAs used, intraoperative and postoperative complications (laryngospasm
, bronchospasm, breath holding, pulmonary aspiration, ventilation difficulties, nausea, and vomiting), and the need for ETI due to inadequate visual surgical field, airway leaks, or inadequate ventilation.
SMBA is characterized by progressive weakness in the lower and upper extremities, bulbar weakness, laryngospasm
, gynecomastia, and tremor and occurs only in adult males [5-7].
is not normal, even though most theatre nurses would have seen this before.
 The four physiological laryngeal airway reflexes are described as (i) closure of both true and false vocal cord with laryngospasm
; (ii) coughing reflex; (iii) expiration reflex; and (iv) spasmodic panting reflex.
Postoperatively pulmonary complications were defined as the existence of severe hypoxemia, laryngeal edema, complete laryngospasm
, pneumothorax, atelectasis, and death.
The use of suxamethonium in children is less common and usually reserved for cases where there is very significant risk of aspiration or severe laryngospasm