Treating stridor with opioids: a challenging case of paradoxical vocal cord movement

Neustein, Steven M.; Taitt-Wynter, Lisa M.; Rosenblatt, Meg A.

doi:10.1016/j.jclinane.2009.02.009

Cited by 7 publications

(3 citation statements)

References 9 publications

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“…The condition is often misdiagnosed and treated as laryngospasm or bronchospasm. The diagnosis can only be made by direct observation of the vocal cords, and responds to treatment with anxiolytic, sedative or opioid agents [50][51][52][53].…”

Section: Dysfunctional Laryngeal Reflexesmentioning

confidence: 99%

Difficult Airway Society Guidelines for the management of tracheal extubation

Mitchell¹,

Dravid²,

Patel³

et al. 2012

Anaesthesia

430

139

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SummaryTracheal extubation is a high‐risk phase of anaesthesia. The majority of problems that occur during extubation and emergence are of a minor nature, but a small and significant number may result in injury or death. The need for a strategy incorporating extubation is mentioned in several international airway management guidelines, but the subject is not discussed in detail, and the emphasis has been on extubation of the patient with a difficult airway. The Difficult Airway Society has developed guidelines for the safe management of tracheal extubation in adult peri‐operative practice. The guidelines discuss the problems arising during extubation and recovery and promote a strategic, stepwise approach to extubation. They emphasise the importance of planning and preparation, and include practical techniques for use in clinical practice and recommendations for post‐extubation care.

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Section: Dysfunctional Laryngeal Reflexesmentioning

confidence: 99%

Difficult Airway Society Guidelines for the management of tracheal extubation

Mitchell¹,

Dravid²,

Patel³

et al. 2012

Anaesthesia

430

139

View full text Add to dashboard Cite

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“…Unlike laryngospasm, which typically results in intense and constant upper airway obstruction, PVCMD is an intermittent upper airway obstruction with a rapid onset, and oxygenation is usually maintained. It has been reported that sedation using midazolam 7 or treatment of pain using fentanyl 8 may be helpful. No specific treatment other than basic airway support is required in most cases.…”

Section: Discussionmentioning

confidence: 99%

“…One such cause of stridor, which has been reported in several case studies, is paradoxical vocal cord motion disorder (PVCMD). [1][2][3][4][5][6][7][8][9] PVCMD is an upper airway obstruction associated with the paradoxical adduction or closure of the vocal folds primarily during inhalation but sometimes during exhalation. All previously reported cases described single events.…”

mentioning

confidence: 99%

Three Episodes of Postanesthesia Paradoxical Vocal Cord Motion Disorder in the Same Patient: A Case Report

Wu,

Zhang

2024

A&A Practice

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Postanesthesia paradoxical vocal cord motion disorder (PVCMD) is often benign. However, if not recognized, PVCMD can lead to unnecessary treatments. Our patient had 3 different surgeries over a period of 20 months. The first episode of PVCMD occurred after a shoulder surgery, and the patient was reintubated. PVCMD was correctly diagnosed and treated successfully with reassurance after an ulnar nerve decompression. The third episode of PVCMD occurred after a cervical fusion surgery. Prevertebral edema from surgery further compromised the airways. Our case demonstrates the challenges of identifying and managing perioperative PVCMD, especially when surgical complications confound the airway management.

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Postoperative Respiratory Distress in the PACU: A Unique Differential Diagnosis

Grovey

Benumof

2019

Clinical Anesthesiology II

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Treating stridor with opioids: a challenging case of paradoxical vocal cord movement

Cited by 7 publications

References 9 publications

Difficult Airway Society Guidelines for the management of tracheal extubation

Difficult Airway Society Guidelines for the management of tracheal extubation

Three Episodes of Postanesthesia Paradoxical Vocal Cord Motion Disorder in the Same Patient: A Case Report

Postoperative Respiratory Distress in the PACU: A Unique Differential Diagnosis

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