Propofol for laryngospasm

Post-extubation laryngospasm is a life-threatening anesthetic emergency that needs prompt treatment. It is a dangerous complication that may lead to hypoxia or negative pressure pulmonary edema. Some studies listed laryngospasm as an anesthetic cause of obstetric mortality. Standard measures described for management of laryngospasm started with removal of the offending stimulus, jaw thrust, and positive airway pressure ventilation with 100% oxygen by bag and mask. When these measures fail, a small dose (0.1 mg/kg) of iv succinylcholine is used. Some studies suggested the use of topical or iv lidocaine. The use of small dose of propofol have been suggested for treatment of resistant laryngospasm in pediatric patients, because of its depressive effect on laryngeal reflexes. Other studies tried a small dose of propofol (0.5 mg/kg) for resistant laryngospasm in obstetric anesthesia.This work aims to compare the effectiveness of a small dose of propofol (0.5 ml/kg) versus lidocaine (1.5 mg/kg) for treatment of resistant post-extubation laryngospasm in obstetric patients, after failure of the standard measures and before the use of muscle relaxants.