Abstract：
Laryngospasm is a rare cause of upper-airway obstruction in adults. It most commonly occurs during light anesthesia. We report a case of severe laryngospasm following rapid sequence induction in an adult requiring an emergency neurosurgical procedure. Laryngospasm occurred despite deep anesthesia with ketamine and neuromuscular blockade with succinylcholine. Several intubation attempts failed. Therefore, 2 hypotheses are considered: succinylcholine resistance and ketamine-induced laryngospasm. To our knowledge, this is the first description of laryngospasm occurring despite deep anesthesia and neuromuscular blockade. An idiosyncratic effect of ketamine may be involved, although this phenomenon has not yet been studied.
摘要：
喉痉挛是成人上呼吸道阻塞的罕见原因。它最常见于轻度麻醉期间。我们报告了一个需要紧急神经外科手术的成年人在快速序列诱导后严重喉痉挛的病例。尽管使用氯胺酮进行深度麻醉并使用琥珀酰胆碱进行神经肌肉阻滞，但仍发生了喉痉挛。几次插管尝试失败。因此,考虑了2种假设：琥珀酰胆碱抗性和氯胺酮诱导的喉痉挛。据我们所知,这是喉痉挛发生的首次描述，尽管深麻醉和神经肌肉阻滞。可能涉及氯胺酮的特殊效应，尽管这种现象尚未被研究。
