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Paediatric laryngospasm — FRCA Final MCQ

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ModerateGeneral AnaesthesiaPaediatric laryngospasmFRCA Final

A 6-year-old boy develops inspiratory stridor, tracheal tug and falling oxygen saturation shortly after removal of a laryngeal mask following squint surgery. There is no capnographic trace during attempted ventilation, the chest is still, and the jaw is clenched. What is the most appropriate anaesthetic technique?

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Correct answer: B — Apply jaw thrust with continuous positive airway pressure and deepen anaesthesia

The picture is laryngospasm during emergence; initial treatment is removal of stimulus, airway manoeuvres, 100% oxygen with continuous positive airway pressure and deepening anaesthesia. If complete laryngospasm persists, a small dose of suxamethonium is appropriate. Atropine is not the primary treatment unless significant bradycardia occurs. Early recognition prevents progression to hypoxaemia and negative-pressure pulmonary oedema.

Reference: APA/DAS paediatric difficult airway guidance; RCoA GPAS paediatric anaesthesia 2022