Does racemic epinephrine (adrenaline) help in the treatment of laryngomalacia?

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Last updated: February 11, 2025View editorial policy

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From the Guidelines

Racemic epinephrine does not have a established role in the treatment of laryngomalacia.

Treatment of Laryngomalacia

  • The treatment of laryngomalacia typically involves surgical interventions, such as supraglottoplasty, which has been shown to improve outcomes in children with persistent obstructive sleep apnea (OSA) 1.
  • There is no mention of racemic epinephrine as a treatment for laryngomalacia in the provided evidence, except in the context of subglottic stenosis, where it may provide temporary relief for patients with mild to moderate symptoms 1.

Use of Racemic Epinephrine

  • Racemic epinephrine may be used to treat post-extubation stridor caused by laryngeal edema, with its effectiveness being quick but transient 1.
  • However, its use in the treatment of laryngomalacia is not supported by the provided evidence, and surgical intervention remains the preferred treatment option.

Conclusion is not allowed, the above statement is the final answer.

From the Research

Treatment of Laryngomalacia

  • The provided studies do not directly address the use of racemic epinephrine in the treatment of laryngomalacia 2, 3, 4, 5, 6.
  • However, some studies discuss the treatment of laryngomalacia and other related conditions, such as subglottic laryngitis and croup.
  • Racemic epinephrine is mentioned as a treatment option for subglottic laryngitis and croup, with some studies suggesting its effectiveness in reducing symptoms 4, 5, 6.

Use of Racemic Epinephrine

  • A study from 1992 compared the efficacy of L-epinephrine and racemic epinephrine aerosols in the treatment of laryngotracheitis (croup) and found that both were effective in reducing symptoms, with no significant differences between the two treatments 5.
  • Another study from 1981 reported the use of simple nebulization of racemic epinephrine in the treatment of acute laryngitis (croup) and found immediate, though transitory, relief of symptoms 6.
  • A study from 2015 discussed changes in the management of subglottic laryngitis over the past 20 years and noted an increase in the use of racemic epinephrine among ENT specialists and pediatricians 4.

Laryngomalacia Treatment

  • Studies 2 and 3 discuss the treatment of laryngomalacia, including surgical options such as epiglottic suture and laser epiglottopexy, as well as medical treatment with antireflux medications.
  • However, these studies do not mention the use of racemic epinephrine as a treatment option for laryngomalacia.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Surgical treatment of severe laryngomalacia: Six month follow up.

Pediatrics international : official journal of the Japan Pediatric Society, 2015

Research

Laryngomalacia.

Pediatric clinics of North America, 2013

Research

[Simple nebulization of racemic epinephrine in the treatment of acute laryngitis (croup) (author's transl)].

Monatsschrift Kinderheilkunde : Organ der Deutschen Gesellschaft fur Kinderheilkunde, 1981

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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