Abstract

PREMEDICATION TIME MANAGEMENT – A CRITICAL STEP IN PREVENTING LARYNGOSPASM

Shahla Haleem*, Manazir Athar, Nazia Tauheed, Abhishek Singh and Nida Fatima

ABSTRACT

Critical airway obstruction/ laryngospasm occurred in immediate recovery phase following anal dilatation in a child. The procedure was performed on face mask with spontaneous ventilation under Ketamine anaesthesia. An analysis of the case scenario showed that co-administration of glycopyrrolate and ketamine was responsible for this spasm due to unblocked oropharyngeal secretion. Glycopyrrolate with an onset time longer than that of ketamine is not able to exhibit its antisialagogue effect when co-administered with ketamine. As a result, the secretions enhanced by ketamine may get pooled and have a potential of causing laryngospasm. Thus, timely management of drug administration plays a critical role in final outcome of the patient.

Keywords: Glycopyrrolate, oropharyngeal secretion, antisialagogue.