Seah T G, Chin N M
Department of Anaesthesia, Tan Tock Seng Hospital, Singapore.
Singapore Med J. 1998 Jul;39(7):328-30.
Severe laryngospasm may occur during inhalational induction of paediatric patients. Effective and rapid treatment of this complication is extremely important to prevent severe hypoxia. The treatment of choice is intravenous suxamethonium if muscle relaxation is desired. However, in the absence of intravenous access, alternate routes of administration have to be considered. The rapidity and the effectiveness in treating laryngospasm by these non-intravenous routes are important to the outcome of the patient. Though the intramuscular route may be relatively slower in onset time (time taken to reach maximum effect of paralysis) compared with the intravenous route, clinical experience so far indicates satisfactory result in the treatment of laryngospasm. Current evidences indicate that the intraosseous route is probably superior to the intramuscular route and comparable to the intravenous route in terms of onset time.
小儿患者在吸入诱导麻醉期间可能会发生严重喉痉挛。有效且迅速地治疗这一并发症对于预防严重缺氧极为重要。若需要肌肉松弛，治疗的首选药物是静脉注射琥珀胆碱。然而，在没有静脉通路的情况下，必须考虑其他给药途径。这些非静脉途径治疗喉痉挛的速度和效果对于患者的预后很重要。尽管与静脉途径相比，肌肉注射途径的起效时间（达到最大麻痹效果所需的时间）可能相对较慢，但迄今为止的临床经验表明，在治疗喉痉挛方面效果令人满意。目前的证据表明，就起效时间而言，骨内途径可能优于肌肉注射途径，且与静脉途径相当。
