Cheng Jenny Zhao, Wang Jingping
Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, USA.
Anesthesia, Harvard Medical School, Boston, USA.
Cureus. 2021 Apr 11;13(4):e14426. doi: 10.7759/cureus.14426.
Laryngospasm is an uncommon complication of anesthesia in adults but more common in pediatric anesthesia, which could present similarly to supraglottic upper airway obstruction. The management of such airway complications is even more difficult in patients with difficult mask ventilation and intubation. Our case illustrated the management of laryngospasm and negative pressure pulmonary edema in a patient with Treacher Collins syndrome. A literature search revealed few previous similar reports. We demonstrated an algorithm to differentiate between the true laryngospasm from the supraglottic upper airway obstruction, the management of laryngospasm in patients with difficult airways, and the recognition and management of negative pressure pulmonary edema as a complication of laryngospasm.
喉痉挛是成人麻醉中少见的并发症，但在小儿麻醉中更为常见，其表现可能与声门上气道梗阻相似。在面罩通气和插管困难的患者中，此类气道并发症的处理更加困难。我们的病例展示了1例患有特雷彻·柯林斯综合征患者的喉痉挛及负压性肺水肿的处理过程。文献检索显示此前鲜有类似报道。我们展示了一种用于区分真性喉痉挛和声门上气道梗阻的算法、处理困难气道患者喉痉挛的方法，以及识别和处理作为喉痉挛并发症的负压性肺水肿的方法。
