Anesthesia for removal of inhaled foreign bodies in children.
BACKGROUND
Foreign body aspiration may be a life-threatening emergency in children requiring immediate bronchoscopy under general anesthesia. Both controlled and spontaneous ventilation techniques have been used during anesthesia for bronchoscopic foreign body removal. There is no prospective study in the literature comparing these two techniques. This prospective randomized clinical trial was undertaken to compare spontaneous and controlled ventilation during anesthesia for removal of inhaled foreign bodies in children.


METHODS
Thirty-six children posted for rigid bronchoscopy for removal of airway foreign bodies over a period of 2 years and 2 months in our institution were studied. After induction with sleep dose of thiopentone or halothane, they were randomly allocated to one of the two groups. In group I, 17 children were ventilated after obtaining paralysis with suxamethonium. In group II, 19 children were breathing halothane spontaneously in 100% oxygen.


RESULTS
All the patients in the spontaneous ventilation group had to be converted to assisted ventilation because of either desaturation or inadequate depth of anesthesia. There was a significantly higher incidence of coughing and bucking in the spontaneous ventilation group compared with the controlled ventilation group (P = 0.0012).


CONCLUSIONS
Use of controlled ventilation with muscle relaxants and inhalation anesthesia provides an even and adequate depth of anesthesia for rigid bronchoscopy.
Soodan
Amit
A
Department of Anaesthesiology, All India Institute of Medical Sciences, New Delhi, India.
Pawar
Dilip
D
Subramanium
Rajeshwari
R
D000768:Anesthesia, General / Q000379:methods*; D018685:Anesthetics, Inhalation / Q000009:adverse effects / Q000627:therapeutic use; D018686:Anesthetics, Intravenous / Q000009:adverse effects / Q000627:therapeutic use; D001784:Blood Gas Analysis / Q000379:methods; D001999:Bronchoscopy / Q000379:methods; D002648:Child; D003371:Cough / Q000209:etiology; D005547:Foreign Bodies / Q000150:complications / Q000628:therapy*; D006221:Halothane / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D001239:Inhalation / Q000502:physiology*; D009467:Neuromuscular Depolarizing Agents / Q000627:therapeutic use; D010100:Oxygen / Q000097:blood; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000379:methods; D013390:Succinylcholine / Q000627:therapeutic use; D013874:Thiopental / Q000009:adverse effects / Q000627:therapeutic use; D014132:Trachea
D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D009467:Neuromuscular Depolarizing Agents; D013390:Succinylcholine; D013874:Thiopental; D010100:Oxygen; D006221:Halothane