Three cases of postextubation stridor due to suspected laryngospasm are described in which a small dose of lignocaine injected intra-tracheally, through the cricothyroid membrane, produced rapid and effective relief of stridor with no early recurrence or side-effects. The procedure was performed safely and quickly and was well tolerated by patients. Transtracheal injection of local anaesthetic should be considered for treatment of postextubation stridor in adults, so long as there is no risk of pulmonary aspiration, and pathological causes of laryngospasm have been excluded.
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9.
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McCullochT.M., FlintP.W., RichardsonM.A., BishopM.J.Lidocaine effects on the laryngeal chemoreflex, mechanoreflex, and afferent electrical stimulation reflex.Ann Otol Rhinol Laryngol1992; 101: 583–589.
13.
RobinsonE.P., RexM.A.E., BrownT.C.K.A comparison of different concentrations of lignocaine hydrochloride used for topical anaesthesia of the larynx of the cat.Anaesth Intensive Care1985; 13: 137–144.
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GurungA.M., TomlinsonA.A.Pre-preparation of succinylcholine: significant waste for questionable benefit (Editorial).Anaesthesia2004; 59: 211–215.
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ChungDC, RowbottomS.J.Avery small dose of suxamethonium relieves laryngospasm.Anaesthesia1993; 48: 229–230.
16.
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17.
GottaA.W., SullivanC.A.Anaesthesia of the upper airway using topical anaesthesia and superior laryngeal nerve block.Br J Anaesth1981; 53: 1055–1058.
18.
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20.
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