Tracheal Foreign Body Removal Research Articles

Combined sevoflurane/sufentanil anesthesia for removal of tracheal foreign bodies in pediatric surgery, and its effect on hemodynamics

Purpose: To determine the efficacy of sevoflurane + sufentanil combination anesthesia in pediatric surgery for removal of tracheal foreign bodies, and its effect on hemodynamics.Methods: A total of 128 children with airway foreign bodies were assigned to control and study groups, each with 64 children. The control patients received slow intravenous injection of propofol (3 mg/kg). The study group was given 5 % sevoflurane and a slow intravenous injection of sufentanil (0.3 μg/kg). Hemodynamic parameters (diastolic blood pressure, systolic blood pressure and heart rate) were recorded before induction of anesthesia, at the time of intubation, during placement of a rigid bronchoscope (when the lens was placed), during removal of foreign bodies, and when extubating. Complications in children in the two groups after the removal of airway foreign body were recorded.Results: At the times of intubation and extubation, blood pressure and heart rate were significantly increased in both groups, but appreciably lower values were seen in study group. The major complications in pediatric airway foreign body removal in two groups were vomiting, bronchospasm and holding of breath.Conclusion: In children with airway extraction, sevoflurane, in combination with sufentanil produced better anesthetic effect and less impact on hemodynamics than propofol. Moreover, the children woke up faster and had fewer complications. The combined anesthesia is safe and reliable. However, the clinical application of this combined anesthesia requires larger-sample clinical studies.

Anesthetic effect and safety of sevoflurane combined with propofol in removing tracheobronchial foreign bodies in children.

To systematically evaluate the anesthetic effect and safety of sevoflurane combined with propofol in removing tracheal foreign bodies in children. PubMed, EMbase, The Cochrane Library, China Biomedicine Database, China National Knowledge Internet, WanFang Data, and VIP databases were searched. Randomized controlled trials (RCTs) of sevoflurane combined with propofol for anesthesia during tracheal foreign body extraction in children were collected. The retrieval time was from the establishment of the database to April 10, 2019. RevMan 5.3 software was used for meta-analysis after two researchers independently screened the literature, extracted data, and evaluated the risk bias included in the study. Seven RCTs involving 473 patients were included. Meta-analysis showed that the time of loss of consciousness significantly reduced (MD=-38.27, 95% CI (-41.77, -34.77), p < 0.00001) and the recovery time significantly reduced (MD=-12.29, 95% CI (-2.77, -1.80), p < 0.00001) in the sevoflurane combined with propofol group compared with the control group. In terms of safety, the heart rate was slower [MD=-11.00, 95% CI (-21.64, -0.36), p=0.04 < 0.05] and the incidence of cough and breath holding was lower [MD=0.38, 95% CI (0.19, 0.78), p=0.008] in the sevoflurane combined with propofol group than in the control group. However, no significant difference in respiratory rate and SPO 2 < 90% was found between the two groups (p > 0.05). Sevoflurane combined with propofol is worth popularizing because of its high anesthetic effect and safety in the removal of tracheal foreign bodies in children. However, given the limited quantity and quality of the included studies, the above conclusions need to be verified by high-quality studies.

A comparison between Sevoflurane Volatile Induction/Maintenance Anesthesia and Propofol Total Intra-venous Anesthesia for Rigid Bronchoscopy under Spontaneous Breathing for Tracheal/Bronchial Foreign Body Removal in Children

Abstract Background Foreign body aspiration is a life-threatening condition. Asphyxiation from inhaled foreign bodies is a leading cause of accidental death among children younger than 4 years. While early clinicians used topical anesthesia, general anesthesia became common place for the removal of aspirated objects with increased experience with the rigid bronchoscope and advances in anesthetic delivery. Inhaled anesthesia and total intravenous anesthesia are widely used for rigid bronchoscopy in children. Objective In this study, we compared sevoflurane VIMA and propofol TIVA, when used for both induction and maintenance of anesthesia in children undergoing rigid bronchoscopy for tracheal or bronchial foreign body removal. Methods This is a prospective double – blinded, randomized controlled Trial, After Approval is obtained from the research ethics committee of anaesthesia and intensive care department, Ain Shams University. Patients were randomly divided into two groups (n = 30 each). In Group VIMA, anesthesia was induced with inhalation of sevoflurane. Before induction, a closed circuit with a 1-l reservoir bag was overflowed by 8 vol % sevoflurane with 0.3 l/min fresh oxygen flow for 3 min. In Group TIVA, a bolus of 2.5 mg/kg propofol was administered over 30 seconds. Additional propofol 0.5–1 mg/kg was given as needed to deepen anesthesia. Results Our results demonstrate that compared with propofol TIVA, sevoflurane VIMA provides more stable haemo-dynamics and respiration, faster induction and recovery and higher incidence of excitement in paediatric patients undergoing tracheal/bronchial foreign body removal. Conclusion Foreign body aspiration is a life-threatening condition. Anesthetic management can be challenging, as the airway is shared with the surgeon and adequate ventilation must be maintained despite airway manipulation.

The application effect and safety evaluation of lidocaine mucilage in children's removal of tracheal foreign body in trachea through bronchoscopy

The application effect and safety evaluation of lidocaine mucilage in children's removal of tracheal foreign body in trachea through bronchoscopy

Study of the laryngeal mask airway for airway management in childrenwith acute severe tracheobronchial foreign body

Objective:To explore the application of laryngeal mask airway in the management of respiratory tract after acute and severe tracheal foreign body removal in children, and to provide a safe and effective treatment for clinical treatment.Method:Seventy cases of children with acute severe tracheal or bronchial foreign body requiring mechanical ventilation transition were randomized to receive, one group was using laryngeal mask airway for airway management after the foreign body was extracted and the bronchoscope was pulled out. Another group was using tracheal intubation. Both groups were received the same general anesthesia induction and maintenance. The blood pressure before induction, before and after insertion of LMA (TT), before and after extubation of LMA(TT) were monitored and recorded. Heart rate, tidal volume,respiratory rate,pulse oxygen saturation, and end-tidal carbon dioxide partial pressure were recorded at the same time in both groups. Airway complications during the recovering between two groups were compared.Result:HR, BP have no significant difference in LMA group before and after implantation LMA (P> 0.05). HR and BP were increased significantly after intubation (P< 0.05) in TT group; Airway pressure, SpO₂ and PET CO₂ exhibited no significant difference between two groups P> 0.05); LMA group has less airway complications than TT group during the recovering.Conclusion:Application of LMA for anesthetic airway management after tracheobronchial foreign body was extracted in children made both less effect on respiratory and circulatory system the regular using tracheal intubation and less damage to the respiratory tract. In addition,the recovery time in LMA group is much shorter than that of TT group.

The application effect and safety analysis of dyclonine in children's removal of tracheal foreign body in trachea through bronchoscopy

The application effect and safety analysis of dyclonine in children's removal of tracheal foreign body in trachea through bronchoscopy

Application of failure mode and effect analysis in nursing care of children with tracheal foreign body removal

Objective To identify the potential risks in the process of nursing care for children with tracheal foreign body removal and improve the skills and the process, to promote the quality of nursing care and the success rate of tracheal foreign body removal. Methods The failure mode and effect analysis (FMEA) were used to analyze the potential risks in children with tracheal foreign body removal, preoperative, intraoperative and postoperative care, and to find out the possible risks in each medical treatment. For pediatric venous puncture technology was not skilled, surgical position placement inappropriate (especially in the case of foreign body removal surgery posture), surgical instruments and equipment management, intraoperative nursing cooperation and observation of the disease, postoperative transfer and other aspects of the transfer of training and improvement. Results The medical risk value (RPN) in the treatment of pediatric tracheal foreign body removal in the process of nursing in the control group was reduced from 1 284.2 to 213.2 of the experimental group. The average value of doctors' satisfaction was increased from 79.33% in the control group to 93.33% in the experimental group,P < 0.05, the difference was statistically significant. Conclusions The use of FMEA in the treatment of pediatric tracheal foreign body removal surgery care and medical risk management improve the quality of surgical care and help improve the success rate of tracheal foreign body removal. It also ensures the safety of the children in the operation process and improves the quality of nursing work. Key words: Failure mode and effect analysis; Removal of tracheal foreign bodies in children; Nursing cooperation; Quality improvement

The effects of different modes of mechanical ventilation under general anesthesia on children undergoing removal of foreign body with bronchofiberscopy

Objective To explore the effects of different ventilation modes of tracheobronchial foreign body in children with fiberoptic operation under general anesthesia. Methods Sixty children (1ys≤age≤3ys) undergoing fiberoptic bronchoscopy tracheal foreign body removal according to the combinations of different ventilation modes during and after fiberoptic bronchoscopy (FOB) procedures were divided into group A [volume control ventilation (VCV) + VCV, n= 20], group B [pressure control ventilation (PCV) + VCV, n= 20] and group C (PCV + PCV, n= 20) randomly. The P mean, P max, and PetCO2 during and after fiberoptic bronchoscopy procedures were monitored. The SpO2, PaO2, and PaCO2 after mechanical ventilation 1.5 hours were recorded. Results Compared to group A, groups B and C had lower P max and P mean (P<0.05) during the FOB procedures. Compared to groups A and B, group C had a lower P max and P mean (P<0.01) after the FOB procedures. At the 1.5 hours after the procedure, all the children showed significant increase in SpO2 and PaO2 (P<0.05) and decrease in PaCO2 (P<0.05) in groups A, B, and C. Conclusions When fiberoptic bronchoscopy in tracheobronchial foreign body operation is applied in children undergoing general anesthesia, the pressure control ventilation (VCV) mode can decrease the pressure of airway (P aw) and PaCO2 than volume control mode during procedure. Key words: Anesthesia, general; Respiration, artificial; Bronchoscopy; Foreign bodies/SU; Tracheal diseases/SU

Two Cases of Pneumothorax and Subcutaneous Emphysema Associated with Removal of Neglected Tracheal Foreign Body

유·소아에서의 기도 이물 흡인은 일상생활에서 비교적 흔 하게 발생하지만 때로는 심각하거나 치명적인 결과를 가져올 수 있는 질환으로, 발생 초기에 정확한 진단과 적절한 치료가 요구된다. 기도 이물로 인한 증상은 무증상에서부터 호흡곤 란 및 청색증에 이르기까지 매우 다양하게 나타날 수 있고, 다 양한 증상들로 인해 기도 이물이 정확히 진단되지 못하고 천 식이나 크루프, 백일해, 폐렴 등의 다른 질환으로 오진이 될 수 도 있다. 기도 이물의 제거를 위해서는 이물의 형태나 크기, 위치, 종류, 환아의 상태 등을 종합적으로 고려하여 전신 마취 하에서 환기 기관지내시경술(ventilating bronchoscopy), 기관 절개술, 흡입술, 개흉술 등의 술식을 선택적으로 사용할 수 있 다. 기도 이물 제거 후 발생하는 피하 기종 및 기흉은 매우 드 물게 보고되고 있는 합병증으로, 기도 내에 이물이 장기간 방 치되었을 경우 이물 제거를 위한 기관기관지경술(tracheobronchoscopy)이나 기관절개술 후 발생하는 경우가 더 많은 것으 로 알려져 있다. 저자들은 최근 장기간 방치된 기도 이물을 진단 받은 환아에서 기관기관지경술 및 기관절개술을 통한 이물 제거 후 발생한 피하 기종과 기흉 2예를 경험하였기에 문 헌 고찰과 함께 이를 보고하는 바이다.

A dose study of remifentanil in combination with propofol during tracheal or bronchial foreign body removal in children

s and Programme: EUROANAESTHESIA 2011: The European Anaesthesiology Congress: Paediatric Anaesthesia and Intensive Care

Sevoflurane based volatile induction/maintenance anesthesia for rigid bronchoscopy for tracheal or bronchial foreign body removal: A better choice than propofol-remifentanil intravenous anesthesia

Sevoflurane based volatile induction/maintenance anesthesia for rigid bronchoscopy for tracheal or bronchial foreign body removal: A better choice than propofol-remifentanil intravenous anesthesia

Ventilatory efficiency of three-way laryngeal mask airway in tracheal foreign body removal

Three-way laryngeal mask airway (tLMA) was used in 31 patients aged 4-68 yr, weighing 10- 79 kg undergoing tracheal foreign body removal under general anesthesia. Anesthesia was induced with propofol 3 mg/kg, vecuronium 0.12 mg/kg and remifentanil 0.4 μg/kg. tLMA was inserted. The patients were mechanically ventilated. Anesthesia was maintained with iv infusion of propofol 2 mg . Kg-1 ? H-1, vecuronium 0.08 mg·kg-1·h-1 and remifentanil 0.15 μg·kg-1 ·min-1 . Radial artery was cannulated for BP monitoring and blood sampling. The operation time was 6-34 min and mechanical ventilation time 19-45 min. There was no significant change in SP, DP, HR, VT, Ppeak and Ppeak CO, during operation as compared with the baseline values before anesthesia. SpO2 was significantly increased at T2-6. PCO2, PO2 and O2sat were obviously improved after tLMA was used. All the patients emerged bom anesthesia within 30 min after operation. No aspiration, obvious gastrointestinal inflation, and pharyngeal and laryngeal edema and injury occurred. Mild agitation occurred in a short time during the recovery period in one patient. No complication occurred. Key words: Laryngeal masks; Foreign bodies; Trachea

A large foreign body in the bronchus: Anaesthetic and Surgical Challenges

Purpose: Sharing the airway with the surgeon and maintaining oxygenation during the removal of a large tracheal or bronchial foreign body (FB) can be challenging. We report the unusual extraction of a large foreign body and the anaesthetic challenges encountered during its removal. Clinical features: A 9 month old baby presented to the emergency department with respiratory distress. Xray chest revealed partial collapse of right lung with mediastinal shift and hyperinflation of left lung. The patient was taken to the operating room for emergency bronchoscopy. Bronchoscopy was done after inhalational induction with sevoflurane. The anaesthetic technique was spontaneous ventilation using isoflurane and intermittent doses of propofol. The surgeon was unable to extract the foreign body due to its large size. After multiple attempts and dislodgement of the FB to the opposite side with severe desaturation, a decision to do tracheotomy was made to extract the FB. The technique of anaesthesia involved changing over from spontaneous to controlled ventilation and endotracheal intubation for immediate management of desaturation. The FB was successfully removed through a tracheotomy with no further adverse events. Conclusion: Complete cooperation and good communication between the surgeon and the anaesthesiologist is very important for the successful outcome of bronchoscopic procedures. When the surgeon has difficulty in extracting the foreign body, due to its large size they may have to resort to methods of removal other than through the oral cavity. Anaesthesiologist may have to alter one's planned technique and be ready to take quick measures in times of unexpected incidents.

Evaluation of propofol-remifentanil total intravenous anaesthesia in children undergoing tracheal foreign body removal

目的 研究瑞芬太尼在小儿气管异物取出术麻醉中的临床效果及安全性.方法 选择美国麻醉学会制定的Ⅰ～Ⅱ级标准、年龄2～4岁、行气管异物取出术小儿40例,随机分为观察组和对照组,每组20例.观察组静脉注射丙泊酚3 mg/kg诱导麻醉,术中维持丙泊酚1.5 mg/(kg·h)微泵注入及瑞芬太尼0.05μg/(kg·min)持续泵注.对照组静脉注射γ-羟丁酸钠90 mg/kg诱导麻醉,术中麻醉深度不足时分次静注氯胺酮1.5 mg/kg至麻醉满意,并根据手术需要分次追加氯胺酮1 mg/kg.记录诱导前(T0),插支气管镜后(T1),拔支气管镜时(T2),清醒时(T3)各时间收缩压、舒张压、心率及动脉血氧饱和度.观察两组苏醒时间,对比两组患儿拔管后上呼吸道梗阻或屏气、苏醒期躁动、术后恶心呕吐的发生率.结果 两组T1与T2时血流动力学变化比较,舒张压差异无显著性(P＞0.05),其他血流动力学指标变化差异有显著性(P＜0.05);观察组患儿气管异物取出术中血流动力学相对平稳,而对照组患儿血流动力学变化较大.瑞芬太尼起效迅速,恶心呕吐、苏醒期躁动、支气管痉挛和术后舌后坠的发生较对照组少,苏醒时间短,而且苏醒效果佳,与对照组相比差异有显著性(P＜0.05).结论 瑞芬太尼、丙泊酚复合静脉麻醉可安全有效地用于小儿气管异物取出术,并具有血流动力学稳定、手术麻醉患儿苏醒时间短和苏醒质量高的优点。

Tracheal foreign bodies in the cat and the use of fluoroscopy for removal: 12 cases

To gather information to support the use of fluoroscopically guided removal of tracheal foreign bodies in cats. It was also the intent to produce a case series and look at the long-term outcome following tracheal foreign body removal. A retrospective study was performed. This looked at cases of tracheal foreign bodies in cats seen at the University of Bristol veterinary school at Langford over an eight-year period. Outcome was assessed via telephone conversations with the owners. Twelve cats were presented with tracheal foreign bodies during this time. Ten of these foreign bodies were successfully removed using fluoroscopy and two using bronchoscopy. All cats survived. Follow-up was available for nine cats and showed no long-term complications. Forceps removal under fluoroscopic guidance is a rapid, safe, and effective method for removal of tracheal foreign bodies in cats. It should be considered as an alternative to bronchoscopy for removal of tracheal foreign bodies in cats. Indeed, in cases where bronchoscopy has failed, it can be attempted to avoid thoracotomy. Successful removal of tracheal foreign bodies in cats is associated with a good long-term outcome.

Removal of an Unexpected Tracheal Foreign Body After Five Months

Foreign body aspiration can produce serious pulmonary diseases. Timely diagnosis and appropriate treatment is important to prevent long-term complications in affected children. We report the case of a 15-month-old child with a 5-month history of regurgitation, vomiting, recurrent tracheobronchitis, and pneumonia. The diagnosis was gastroesophageal reflux. The laryngotracheal endoscopy revealed a rabbit vertebra partially obstructing the airway at the level of the cricoid cartilage. With a rigid bronchoscope and forceps equipped with a telescope, it was possible to disengage and extract the foreign body. Six months later endoscopic control revealed no residual alterations in the larynx and trachea.

Anesthesia for Tracheal or Bronchial Foreign Body Removal in Children: An Analysis of Ninety-Four Cases

Anesthesia for Tracheal or Bronchial Foreign Body Removal in Children: An Analysis of Ninety-Four Cases

Anesthesia for tracheal or bronchial foreign body removal in children: an analysis of ninety-four cases.

This report is a description of the ventilation techniques used in 94 children undergoing general anesthesia for foreign body removal of the bronchus. No particular technique was found to be associated with a greater incidence of adverse outcomes.

気管・気管支異物摘出中，摘出後の合併症 症例を中心として

気管・気管支異物摘出中，摘出後の合併症 症例を中心として