Discovery of hazardous foreign bodies observed during anesthetic practice

Jasim M Salman

doi:10.33762/mjbu.2015.108393

Abstract

Background: In anesthesia practice, obstructing materials like thick mucus secretion, debris or blood clots, and food particles accumulate in the oropharynx. If not properly removed, they could cause airway obstruction with concurrent hypoxia which may end fatally. Objectives: This study aims to highlight the importance of forgetting foreign objects in the airway in order to allert anesthesiologists about the hazards of missed foreign bodies in the oropharynx which could lead to disastrous situation. Patients and Methods: During the period from 2012-2014, out of 2300 patients presented for surgical operation under general anesthesia with endo-tracheal intubation, 22 patients were recorded to have accidental discovery of hazardous foreign bodies retained in the oropharynx and were included in this study with an incidence rate of 0.96%. Cases in this study were classified as patient-related or surgery-related. Foreign bodies were identified with the aid of laryngoscopy and were removed by suction hand piece or Magill's forceps. Results: The main age group was between 21-40 years accounting for 45.5%. Male: female ratio was 1.2:1. Overall, 59.1% were related to patients' causes, while 40.9% were related to surgery. The commonest type of foreign body observed was cardamom (38.5%) among patient-related cases, and tissue remnants in 66.7% of surgery-related cases. Conclusion: Missed foreign bodies are not uncommon and anesthesiologists should be aware of inspecting the mouth and throat of the patient thoroughly before endotracheal intubation and extubation to reduce the hazard of foreign body inhalation.

Highlights

K eeping a clear airway is a fundamental goal of the anesthesiologist
The interesting observation in this study is the detection of foreign bodies that seem to be overlooked by the patient or by the surgeon and even by the anesthesiologist
Different hazardous foreign bodies were lodged in the mouth with potential risk to cause respiratory obstruction; others were found in the nasopharynx mainly from nasal operations in the form of tissue remnants and medical elements

Summary

Introduction

K eeping a clear airway is a fundamental goal of the anesthesiologist. many circumstances hamper achieving this aim during the course of anesthesia such as oropharyngeal foreign material which may cause airway blockage. ‫ لتسليط الضوء على خطورة نسيان اجسام غريبة في مجرى التنفس اثناء العمليات الجراحية وتنبيو أطباء التخدير حول مخاطر الأجسام‬:‫الأىداف‬ .‫الغريبة في تجويف الفم والبلعوم مما قد يؤدي إلى حالةكارثية‬ Any missed foreign body in the oropharynx may be inhaled causing airway obstruction with subsequent hypoxia and atelectasis.

Objectives

Results

Conclusion