Case Scenario: Perianesthetic Management of Laryngospasm in Children Case Scenario: Perianesthetic Management of Laryngospasm in Children Case Scenario: Perianesthetic Management of Laryngospasm in Children Case Scenario: Perianesthetic Management of Laryngospasm in Children Anesthesiology. ANESTHESIOLOGY 1996; 85:47580, Nishino T: Physiological and pathophysiological implications of upper airway reflexes in humans. The laryngospasm abates, and the patient becomes easier to ventilate. ANESTHESIOLOGY 1956; 17:56977, Crawford MW, Rohan D, Macgowan CK, Yoo SJ, Macpherson BA: Effect of propofol anesthesia and continuous positive airway pressure on upper airway size and configuration in infants. Laryngospasm: Stimulation of vagus nerve during light anesthesia (Superior Laryngeal n, pharyngeal br of vagus, recurrent laryngeal below cords). Suxamethonium injection in a hypoxic patient may lead to severe bradycardia and even to cardiac arrest. Khanna S (expert opinion). Laryngospasm in amyotrophic lateral sclerosis. Laryngospasm (luh-RING-o-spaz-um) is a condition in which your vocal cords suddenly spasm (involuntarily contract or seize). OVERVIEW Laryngospasm is potentially life-threatening closure of the true vocal chords resulting in partial or complete airway obstruction unresponsive to airway positioning maneuvers. For the management of laryngospasm in children, this task is complicated by two facts. Policy. The authors also thank Frank Schneider (Editing Coordinator, Division of Communication and Marketing of the Geneva University Hospitals, Geneva University Hospitals) and Justine Giliberto (Editing, Division of Communication and Marketing of the Geneva University Hospitals) for editing the video material. If breathing exercises and pushing on your laryngospasm notch dont relieve your symptoms, call 911 or head to the nearest emergency room. The highest incidence of laryngospasm is found in procedures involving surgery and manipulations of the pharynx and larynx.2,5,,7The incidence of laryngospasm, after tracheal extubation, has already been reported to exceed 20% and be as high as 26.5% in pediatric patients who have undergone tonsillectomy.14,,17Urgent procedures also carry a higher risk of laryngospasm than elective procedures. Therefore, giving IV atropine before IV injection of suxamethonium to treat laryngospasm is mandatory.66. Do Children Who Experience Laryngospasm Have an Increased Risk of Upper Respiratory Tract Infection? In the case of laryngospasm, basic appropriate airway manipulations such as chin lift, jaw thrust, and oral airway insertion in combination with CPAP can be demonstrated and practiced with these models. Laryngospasm remains the leading cause of perioperative cardiac arrest from respiratory origin in children.1, The upper airway has several functions (swallowing, breathing, and phonation) but protection of the airway from any foreign material is the most essential. Laryngospasm is the sustained closure of the vocal cords resulting in the partial or complete loss of the patient's airway. Sufentanil (1 mcg) was given intravenously and the surgeon was allowed to proceed 5 min later. This site uses Akismet to reduce spam. He had been fasting for the past 6 h. Preoperative evaluation was normal (systemic blood pressure 85/50 mmHg, heart rate 115 beats/min, pulse oximetry [SpO2] 99% on room air). These preliminary results are interesting and need to be confirmed by further studies. Pulmonary complications. Anesthesiology 2012; 116:458471 doi: https://doi.org/10.1097/ALN.0b013e318242aae9. Minimally invasive anti-reflux procedures, Advertising and sponsorship opportunities. Breathe in and out through the straw without pausing between the inhale and the exhale. It is frequently observed in fetuses and newborns, whereas later on, laryngeal closure reflex and cough become predominant.21This developmental pattern may be implicated in sudden infant death. font-weight: normal; Paediatr Anaesth 2008; 18:2818, Hampson-Evans D, Morgan P, Farrar M: Pediatric laryngospasm. Place a straw in your mouth and seal your lips around it. Furthermore, the efficacy of propofol to break complete laryngospasm when bradycardia is present has been questioned.4In our case, two bolus doses of 5 mg IV propofol (each representing a dose of 0.6 mg/kg) were administered but did not relieve airway obstruction. You may opt-out of email communications at any time by clicking on Paediatr Anaesth 2002; 12:6258, Batra YK, Ivanova M, Ali SS, Shamsah M, Al Qattan AR, Belani KG: The efficacy of a subhypnotic dose of propofol in preventing laryngospasm following tonsillectomy and adenoidectomy in children. It is a primitive protective airway reflex that exists to . Even though laryngospasm isnt usually serious or life-threatening, the experience can be terrifying. J Anesth 2010; 24:8547, Schroeck H, Fecho K, Abode K, Bailey A: Vocal cord function and bispectral index in pediatric bronchoscopy patients emerging from propofol anesthesia. Laryngospasm may be preceded by a high-pitched inspiratory stridor some describe a characteristic crowing noise followed by complete airway obstruction. The efficacy of lidocaine to either prevent or control extubation laryngospasm has been studied since the late 1970s.62Some articles have confirmed the efficacy of lidocaine for preventing postextubation laryngospasm, whereas others have found the opposite results to be true.16,63,,65A recent, well-conducted, randomized placebo-controlled trial in children undergoing cleft palate surgery demonstrated the effectiveness of IV lidocaine (1.5 mg/kg administered 2 min after tracheal extubation) in reducing laryngospasm and coughing (by 29.9% and 18.92%, respectively).64However, these favorable results were not confirmed in other studies.5,65The role of lidocaine (IV or topical) in preventing laryngospasm is still controversial. Otolaryngol Head Neck Surg 1998; 118:8802, Gulhas N, Durmus M, Demirbilek S, Togal T, Ozturk E, Ersoy MO: The use of magnesium to prevent laryngospasm after tonsillectomy and adenoidectomy: A preliminary study. Identifying patients at increased risk for laryngospasm and taking recommended precautions are the most important measures to prevent laryngospasm (fig. A computer-aided incidence study in 136,929 patients Acta Anaesthesiol Scand 1984; 28:56775, Burgoyne LL, Anghelescu DL: Intervention steps for treating laryngospasm in pediatric patients. Qual Saf Health Care 2005; 14:e3, Fernandez E, Williams DG: Training and the European Working Time Directive: A 7 year review of paediatric anaesthetic trainee caseload data. In a more recent series, the overall incidence of laryngospasm was lower8but the predominance of such incidents at a young age was still clear: 50 to 68% of cases occurred in children younger than 5 yr. Review/update the These cookies track visitors across websites and collect information to provide customized ads. Singapore Med J 1998; 39:32830, Warner DO: Intramuscular succinylcholine and laryngospasm. GillesA. Orliaguet, Olivier Gall, GeorgesL. Savoldelli, Vincent Couloigner, Bruno Riou; Case Scenario: Perianesthetic Management of Laryngospasm in Children. ANESTHESIOLOGY 2005; 103:11428, Patel RI, Hannallah RS, Norden J, Casey WF, Verghese ST: Emergence airway complications in children: A comparison of tracheal extubation in awake and deeply anesthetized patients. There is controversy in the literature regarding the use of inhalational or IV induction agents and associated risk of laryngospasm. PEEP! health information, we will treat all of that information as protected health Alterations of upper airway reflexes may occur in several conditions. Advertisement cookies are used to provide visitors with relevant ads and marketing campaigns. Laryngospasm is a frightening condition that happens when your vocal cords suddenly seize up, making breathing more difficult. It is not the same as choking. More needed than oxygen! This is because your vocal cords are contracted and closed tight during a laryngospasm. The patient is unconscious and initially breathing easily with an oral airway in place. Any cookies that may not be particularly necessary for the website to function and is used specifically to collect user personal data via analytics, ads, other embedded contents are termed as non-necessary cookies. If you or someone youre with is having a laryngospasm, you should: In addition to the techniques outlined above, there are breathing exercises that can help you through a laryngospasm. Learning outcomes are difficult to measure. Table 1. First-level studies evaluate the effect of training in a controlled environment (in simulation). Click here for an email preview. Our providers specialize in head and neck surgery and oncology; facial plastic and reconstructive surgery; comprehensive otolaryngology; laryngology; otology, neurotology and lateral skull base disorders; pediatric otolaryngology; rhinology, sinus and skull base surgery; surgical sleep; dentistry and oral and maxillofacial surgery; and allied hearing, speech and balance services. However, some authors have observed that emergence from anesthesia tends to become the most critical period, possibly in relation to changes in practice including the use of laryngeal mask airway (LMA) and/or of propofol and newer inhalational agents.8, Laryngospasm can result in life-threatening complications, including severe hypoxia, bradycardia, negative pressure pulmonary edema, and cardiac arrest. Laryngospasm is a sudden spasm of the vocal cords. The anesthesia staff has called for the fiberoptic intubation set and is preparing to perform fiberoptic intubation. Upper respiratory tract infection (URI) is associated with a twofold to fivefold increase in the risk of laryngospasm.5,9Anesthesiologists in charge of pediatric patients should be aware that the risks associated with a URI in an infant are magnified in this age group, especially in those with respiratory syncytial virus infection.10Children with URI are prone to develop airway (upper and bronchial) hyperactivity that lasts beyond the period of viral infection. Call for help early. To avoid significant morbidity and mortality, the use of a structured algorithm has been proposed.8,70One study suggests that if correctly applied, a combined core algorithm recommended for the diagnosis and management of laryngospasm would have led to earlier recognition and/or better management in 16% of the cases.70These results should encourage physicians to implement their own structured algorithm for the diagnosis and management of laryngospasm in children in their institutions. 3, 5, 7 In both partial and complete laryngospasm, signs of varying degrees of airway obstruction, such as suprasternal retraction, supraclavicular retractions, tracheal tug, 1).3The second step relies on the emergent treatment of established laryngospasm occurring despite precautions (fig. Mayo Clinic on Incontinence - Mayo Clinic Press, NEW The Essential Diabetes Book - Mayo Clinic Press, NEW Ending the Opioid Crisis - Mayo Clinic Press, FREE Mayo Clinic Diet Assessment - Mayo Clinic Press, Mayo Clinic Health Letter - FREE book - Mayo Clinic Press. 1. ANESTHESIOLOGY 2007; 107:7149, Tait AR, Burke C, Voepel-Lewis T, Chiravuri D, Wagner D, Malviya S: Glycopyrrolate does not reduce the incidence of perioperative adverse events in children with upper respiratory tract infections. Here are a couple of techniques to try during an attack: Because laryngospasm happens suddenly without warning, theres really no way to prevent it. A "can't ventilate, can't intubate" scenario may be prolonged when rocuronium is administered. However, the acquisition and the mastering of these skills during specialty training and their maintenance during continuing medical education represent a formidable challenge. can occur spontaneously, most commonly associated with extubation or ENT procedures CAUSES Local extubation especially children with URTI symptoms Br J Anaesth 1998; 81:6925, Krodel DJ, Bittner EA, Abdulnour R, Brown R, Eikermann M: Case scenario: Acute postoperative negative pressure pulmonary edema. A laryngospasm is a muscle spasm in the vocal cords that can lead to problems with speaking and breathing. The procedure was expected to be very short, and general anesthesia with inhalational induction and maintenance, but without tracheal intubation, was planned. The afferent nerve involved in laryngeal closure reflex is the superior laryngeal nerve. Qual Saf Health Care. Case Scenario Perianesthetic Management of Laryngospasm In; Hazard Identification and Risk Assessment; Permit to Work Ensuring a Safe Work Environment Introduction Industrial Workers Face Many Hazards in Their Daily Routines; Health Surveillance Employer's Pack; Incidence and Associated Factors of Laryngospasm Among Pediatric The anesthesiologist assesses that the head/neck could be placed in a more ideal position . ANESTHESIOLOGY 1997; 87:136872, Mazurek AJ, Rae B, Hann S, Kim JI, Castro B, Cot CJ: Rocuronium, Cheng CA, Aun CS, Gin T: Comparison of rocuronium and suxamethonium for rapid tracheal intubation in children. , the overall incidence of respiratory adverse events seems to be higher in children who were awake when their LMA was removed and lower in those who were awake when their endotracheal tube was removed.5In summary, evidence seems to favor deep LMA and awake ETT removal. So, treatment often involves finding ways to stay calm during the episode. It is mandatory to procure user consent prior to running these cookies on your website. An IV line was obtained at 11:15 PM, while the child was manually ventilated. Manipulation of the airway at an insufficient depth of anesthesia is a major cause of laryngospasm. Afferent nerves converge in the brainstem nucleus tractus solitarius. Laryngospasms are rare and typically last for fewer than 60 seconds. Prevention and Treatment of Laryngospasm in the Pediatric Patient: A Literature Review. PubMed PMID. The patient will then develop worsened hypotension, requiring the start of an epinephrine infusion. Get useful, helpful and relevant health + wellness information. Their motoneurons are located in the brainstem nucleus ambiguous and the adjacent nucleus retroambigualis. If laryngospasms are due to anxiety, then anti-anxiety meds can help ease your spasms. Attempt airway maneuvers such as jaw thrust and nasal airway. Acta Anaesthesiol Scand 1999; 43:10813, Visvanathan T, Kluger MT, Webb RK, Westhorpe RN: Crisis management during anaesthesia: Laryngospasm. He is one of the founders of theFOAMmovement (Free Open-Access Medical education) and is co-creator oflitfl.com,theRAGE podcast, theResuscitologycourse, and theSMACCconference. Jpn J Physiol 2000; 50:314, Thompson DM, Rutter MJ, Rudolph CD, Willging JP, Cotton RT: Altered laryngeal sensation: A potential cause of apnea of infancy. Keep the airway clear and monitor for negative pressure pulomnary oedema. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. ANESTHESIOLOGY 1998; 89:12934, Reber A, Paganoni R, Frei FJ: Effect of common airway manoeuvres on upper airway dimensions and clinical signs in anaesthetized, spontaneously breathing children. They are most likely located in the medullary neuronal network rather than in the brainstem.2223The higher center seems to regulate upper airway reflexes. Postoperative negative pressure pulmonary edema typically occurs in response to an upper airway obstruction, where patients can generate high negative intrathoracic pressures, leading to a postrelease pulmonary edema. Laryngospasm (luh-RING-go-spaz-um) is a transient and reversible spasm of the vocal cords that temporarily makes it difficult to speak or breathe. As your vocal cords slowly relax and open, you may hear a high-pitched sound (stridor). In this case, some equipment has high usage demands and becomes scarce throughout the unit. If youve had recurring laryngospasms, you should see your healthcare provider to find out whats causing them. Several studies suggest that deep extubation reduces this incidence, whereas others observed no difference.5,3435In one study, tracheal intubation with deep extubation was associated with increased respiratory adverse events rate (odds ratio = 2.39) compared with LMA removal at a deep level of anesthesia, whereas use of a facemask alone decreased respiratory adverse events (odds ratio = 0.15).35The difference between LMA and ETT was less evident when awake extubation was used (odds ratio = 0.65 and 1.26, respectively). Laryngospasm can sometimes occur after an endotracheal tube is removed from the throat. Laryngospasm is usually defined as partial or complete airway obstruction associated with increasing abdominal and chest wall efforts to breathe against a closed glottis.3,5,7In both partial and complete laryngospasm, signs of varying degrees of airway obstruction, such as suprasternal retraction, supraclavicular retractions, tracheal tug, paradoxical chest, and abdominal movements may be seen.3In addition, inspiratory stridor may be heard in partial laryngospasm but is absent in complete spasm. clear: left; PubMed PMID: Salem MR, Crystal GJ, Nimmagadda U. Past medical history was unremarkable except for an episode of upper respiratory tract infection 4 weeks ago. This paper discusses a case study where the patient had laryngospasm, it also looks at the pathophysiology, risk factors and management of . However, children younger than 3 yr may develop 510 URI episodes per year. Children are more prone to laryngospasm than adults, with laryngospasm being reported more commonly in children (17.4/1,000) than in the general population (8.7/1,000).2,5,,7In fact, the incidence of laryngospasm has been found to range from 1/1,000 up to 20/100 in high-risk surgery (i.e. In fact, when the inspiratory stridulous noise was noted again, the patient was receiving 2% end-tidal sevoflurane and 50% N2O, representing barely 1 minimum alveolar concentration in an infant. information highlighted below and resubmit the form. Recognizing laryngospasm - laryngospasm can occur spontaneously and be life-threatening, making it important that you be able to recognize it immediately. Laryngospasm is identied by varying degrees of airway obstruction with paradoxical chest move-ment, intercostal recession and tracheal tug. include protected health information. Below a cardiac temperature of 28C, the heart may suddenly and spontaneously arrest. Unfortunately, laryngospasms usually happen quickly. This content does not have an Arabic version. Paediatr Anaesth 2004; 14:15866, Olsson GL, Hallen B: Laryngospasm during anaesthesia. display: inline; suggests that maintenance with sevoflurane was associated with a higher incidence of laryngospasm compared with propofol (relative risk 2.37, 95% CI 1.493.76; P< 0.0001).5In our case, the second episode of laryngospasm occurred while the patient was under light anesthesia. Paediatr Anaesth 2002; 12:7629, Tait AR, Pandit UA, Voepel-Lewis T, Munro HM, Malviya S: Use of the laryngeal mask airway in children with upper respiratory tract infections: A comparison with endotracheal intubation. It may be difficult for a nonspecialist pediatric anesthesiologist to adequately manage an inhalational induction, because of the possibility to fail to manage the airway properly or the inability to recognize and treat early a stridor/laryngospasm. Cleveland Clinic is a non-profit academic medical center. Management There are a number of ways reported to reduce the incidence of laryngospasm (9). These risk factors can be patient-, procedure-, and anesthesia-related (table 1). privacy practices. Anesth Analg 1991; 72:2828, Garca CG, Bhore R, Soriano-Fallas A, Trost M, Chason R, Ramilo O, Mejias A: Risk factors in children hospitalized with RSV bronchiolitis, Tait AR, Malviya S, Voepel-Lewis T, Munro HM, Seiwert M, Pandit UA: Risk factors for perioperative adverse respiratory events in children with upper respiratory tract infections. Usually, laryngospasm resolves and the patient recovers quickly without any sequelae. In reports addressing respiratory adverse events, including laryngospasm, the overall incidence of perioperative respiratory events as well as the incidence of laryngospasm was higher in 01-yr-old infants in comparison with older children.2,5,,7The risk of perioperative respiratory adverse event was quoted as decreasing by 8% for each increasing year of age.2A recent large cohort study confirmed this inverse relationship between age and risk of perioperative respiratory adverse events.5This study showed that the relative risk for perioperative respiratory adverse events, particularly laryngospasm, decreased by 11% for each yearly increase in age.5. He created the Critically Ill Airway course and teaches on numerous courses around the world. Accessed Nov. 5, 2021. These cookies help provide information on metrics the number of visitors, bounce rate, traffic source, etc. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7361892/). Many methods and techniques of airway manipulation have been proposed. None of the children in the chest compression group developed gastric distension (86.5% in the standard group). Broaddus VC, et al. Mayo Clinic is a nonprofit organization and proceeds from Web advertising help support our mission. Search for other works by this author on: Bhananker SM, Ramamoorthy C, Geiduschek JM, Posner KL, Domino KB, Haberkern CM, Campos JS, Morray JP: Anesthesia-related cardiac arrest in children: Update from the Pediatric Perioperative Cardiac Arrest Registry. Laryngospasms are rare and typically last for fewer than 60 seconds. #mc-embedded-subscribe-form input[type=checkbox] { The goal is to slow your breathing and allow your vocal cords to relax. margin-top: 20px; You might experience multiple laryngospasms in a brief time but in most cases, each episode ends after about a minute. It is most commonly occurring on induction or emergence phases and can have serious life threatening consequences. He is retaining oxygen saturations > 94 percent. The final decision depends on the severity of the laryngospasm (i.e. It should be noted that hypoxia ultimately relaxes the vocal cords and permits positive pressure ventilation to proceed easily. If we combine this information with your protected This function involves several upper airway reflexes: the laryngeal closure reflex, which consists of vocal fold adduction; apnea; swallowing; and coughing.19To efficiently protect the airway, laryngeal closure reflex must be coordinated with swallowing. Perianesthetic Management of Hypertrophic Cardiomyopathy, Copyright 2023 American Society of Anesthesiologists. Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Continuous Professional Development, Mayo Clinic School of Graduate Medical Education. Understanding the mechanics of laryngospasm is crucial for proper treatment. Mayo Clinic does not endorse companies or products. Can J Anaesth 1988; 35:938, Fink BR: The etiology and treatment of laryngeal spasm. Mayo Clinic offers appointments in Arizona, Florida and Minnesota and at Mayo Clinic Health System locations. The purpose of this case scenario is to highlight keypoints essential for the prevention, diagnosis, and treatmentof laryngospasm occurring during anesthesia. Training . , partial or complete) and of the bradycardia as well as the existence of contraindication to succinylcholine. Evidence on this subject is scarce, but the study by von Ungern-Sternberg et al. They can perform an examination and find out if there are ways to prevent laryngospasm from happening in the future. ANESTHESIOLOGY 2009; 110:28494, Baraka A: Intravenous lidocaine controls extubation laryngospasm in children. Indian J Anaesth 2010; 54:1326, Behzadi M, Hajimohamadi F, Alagha AE, Abouzari M, Rashidi A: Endotracheal tube cuff lidocaine is not superior to intravenous lidocaine in short pediatric surgeries. have demonstrated an increased risk for laryngospasm only when cold symptoms were present on the day of surgery or less than 2 weeks before.28This finding was recently confirmed by the same team in an extensive study involving 9,297 surgical procedures.5Rescheduling patient 23 weeks after an URI episode appears to be a safe approach. padding-bottom: 0px; ANESTHESIOLOGY 2006; 105:4550, Meier S, Geiduschek J, Paganoni R, Fuehrmeyer F, Reber A: The effect of chin lift, jaw thrust, and continuous positive airway pressure on the size of the glottic opening and on stridor score in anesthetized, spontaneously breathing children. He is on the Board of Directors for theIntensive Care Foundationand is a First Part Examiner for theCollege of Intensive Care Medicine. It occurs during general or local anesthesia, natural sleep (rapid eye movement phase of sleep), hypercapnia, and hypoxia, as well as various muscular, neuromuscular junction, or peripheral nerves disorders affecting the efferent neural pathway and effector organs of upper airway reflexes.19, This condition arises as a result of an exaggerated and prolonged laryngeal closure reflex that can be triggered by mechanical (manipulation of pharynx or larynx) or chemical stimuli (e.g. (#2) With steroid and antibiotic, most patients will gradually improve. ANESTHESIOLOGY 1963; 24:585, Al-Metwalli RR, Mowafi HA, Ismail SA: Gentle chest compression relieves extubation laryngospasm in children. Second-level studies attempt to document the transfer of skills to the clinical setting and patient care. Portuguese. In the largest study published in the literature (n = 136,929 adults and children), the incidence of laryngospasm was 1.7% in 09 yr-old children and only 0.9% in older children and adults.7The highest incidence (more than 2%) was found in preschool age groups. Analytical cookies are used to understand how visitors interact with the website. (https://pubmed.ncbi.nlm.nih.gov/34817079/), Visitation, mask requirements and COVID-19 information, chronic obstructive pulmonary disease (COPD). Avoid breathing in through your nose. Inexperience of the anesthetist is also associated with an increased incidence of laryngospasm and perioperative respiratory adverse events.2,5,18Some factors are associated with a lower risk of laryngospasm: IV induction, airway management with facemask, and inhalational maintenance of anesthesia.5Induction and emergence from anesthesia are the most critical periods. The video and the script are intended to illustrate the proper application of the management algorithm, to illustrate the technical and the nontechnical skills required in clinical practice, and to be a resource for the readers who wish to develop their own training sessions. The SimBaby simulator represents a 9-month-old pediatric patient and provides a highly realistic manikin that meets specific learning objectives focusing on initial assessment and treatment. The diagnosis of laryngospasm is made and treated, only to reveal persistent hypoxemia and negative-pressure pulmonary edema (NPPE). Thereafter, surgery was quickly completed, while tracheal extubation and postoperative recovery were uneventful. The next step in management depends on whether laryngospasm is partial or complete and if it can be relieved or not. }, #FOAMed Medical Education Resources byLITFLis licensed under aCreative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Laryngospasms that are caused by other conditions like asthma, stress or hypersensitivity arent usually dangerous or life-threatening. The locations of involved nerve receptors vary as a function of the upper airway reflex: pharyngeal mucosa for the swallowing reflex, supraglottic larynx for laryngeal closure reflex,19larynx and trachea for cough, and any part of the upper airway (but mainly nose and larynx) for apnea. Laryngospasm. Collins S, Schedler P, Veasey B, Kristofy A, McDowell M. Epidemiology of Laryngospasm in Pediatric Patients Children are more prone to laryngospasm than adults, with laryngospasm being reported more commonly in children 1,000).2,5-7 In fact, the incidence of laryngospasm has been gery (i.e., otolaryngology surgery).2,5-7 Many factors may increase the risk of laryngospasm.