In a randomized clinical trial comparing propofol (0.5 mg/kg) to lidocaine (1 mg/kg) for preventing laryngospasm in pediatric tonsillectomy, propofol proved more effective. The study revealed that propofol significantly reduced the incidence of laryngospasm, agitation, nausea, and vomiting within 10 minutes post-extubation compared to lidocaine. However, no significant differences were observed between the two groups in terms of blood pressure, oxygen saturation, awakening time, or recovery duration. Propofol's superior efficacy makes it a valuable option for anesthesia providers managing laryngospasm in this context.
Magnesium (15 mg/kg IV) has been shown to reduce laryngospasm frequency after awake extubation in pediatric adenotonsillectomy patients, likely due to its effects on increasing anesthetic depth and muscle relaxation. While promising, further studies are needed to confirm its role in preventing laryngospasm.
Lidocaine has been explored for laryngospasm prevention both topically and intravenously. IV lidocaine (1.5–2 mg/kg) before extubation has produced mixed results, with studies showing varying effectiveness. Topical lidocaine (4 mg/kg) applied to the larynx before intubation has shown a slight reduction in laryngospasm incidence.
Atropine, believed to lower the risk of laryngospasm by reducing pharyngeal secretions, has not been proven effective.
