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PEDIATRIC ANESTHESIA

The Incidence of Laryngospasm with a "No Touch" Extubation Technique After Tonsillectomy and Adenoidectomy

Ban C. H. Tsui, MD MSc, FRCP(C)^*, Alese Wagner, BSc^*, Dominic Cave, MB FRCP(C)^*, Clark Elliott, MD FRCS, Hamdy El-Hakim, MD FRCS(Ed), FRCS(ORL), and Stephan Malherbe, MB ChB, FCA(SA), MMed(Anes)^*

*Department of Anesthesiology and Pain Medicine and Department of Surgery, University of Alberta Hospitals, Edmonton, Canada

Address correspondence and reprint requests to Ban C.H. Tsui, MSC, MD, FRCP(C), Department of Anesthesiology and Pain Medicine, University of Alberta Hospitals, 3B2.32 Walter Mackenzie Health Science Centre, 8440-112 Street, Edmonton, Alberta, Canada T6G 2B7. Address e-mail to btsui{at}ualberta.ca

In this case series, we evaluated the incidence of laryngospasm using a clearly defined awake tracheal extubation technique in 20 children undergoing elective tonsillectomy with or without adenoidectomy. This technique required patients to be turned to the recovery position at the end of the procedure before discontinuing the volatile anesthetics. No further stimulation, besides continuous oximetry monitoring, was allowed until the patients spontaneously woke up ("no touch" technique). The incidence of laryngospasm, oxygen saturation, and coughing was recorded. No cases of laryngospasm, oxygen desaturation, or severe coughing occurred in our patient population.

IMPLICATIONS: This study re-emphasizes the importance of a sound anesthetic technique in tracheally extubating pediatric patients.

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