title: Anesthesia with sevoflurane and remifentanil under spontaneous respiration assisted with high-frequency jet ventilation for tracheobronchial foreign body removal in 586 children.
abstract: BACKGROUND
  Foreign body aspiration is a common life-threatening event in young children. Tracheobronchial foreign body removal is usually performed by rigid tracheobronchoscopy under general anesthesia. Anesthetic and ventilation techniques vary greatly among anesthesiologists and institutions. In the present retrospective study, we report our anesthetic experience over 5 years. We describe complications and outcomes and analyze the clinical characteristics of anesthesia and ventilation.
  
  
  METHODS
  We retrospectively reviewed relevant clinical findings of 586 pediatric patients treated with rigid tracheobronchoscopy under general anesthesia. All procedures were performed under inhaled sevoflurane anesthesia combined with remifentanil infusion, with spontaneous respiration assisted by high-frequency jet ventilation (HFJV) and topical airway anesthesia.
  
  
  RESULTS
  Among 586 patients, the foreign body was successfully removed by rigid tracheobronchoscopy in 558 patients, and no foreign body was found in 28 patients. Laryngospasm was observed during the procedure in five patients. Hypoxemia was observed in 15 patients (2.6%). No severe complications or deaths occurred. The mean operation time was 22 min and the average hospital stay was 2 days.
  
  
  CONCLUSIONS
  Inhaled sevoflurane anesthesia combined with remifentanil infusion, with spontaneous respiration assisted by HFJV and topical airway anesthesia, is safe and effective for tracheobronchial foreign body removal.
authors.affiliation: Department of Anesthesiology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China.
authors.forename: Sheng
authors.initials: S
authors.lastname: Hu
authors.forename: Hai-long
authors.initials: HL
authors.lastname: Dong
authors.forename: Yan-yan
authors.initials: YY
authors.lastname: Sun
authors.forename: Dong-fang
authors.initials: DF
authors.lastname: Xiong
authors.forename: Hao-peng
authors.initials: HP
authors.lastname: Zhang
authors.forename: Shao-yang
authors.initials: SY
authors.lastname: Chen
authors.forename: Li-ze
authors.initials: LZ
authors.lastname: Xiong
mesh_terms: D000768:Anesthesia, General / Q000379:methods*; D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D001980:Bronchi; D001999:Bronchoscopy; D002648:Child; D005260:Female; D005547:Foreign Bodies / Q000601:surgery*; D006611:High-Frequency Jet Ventilation; D006801:Humans; D008297:Male; D008738:Methyl Ethers; D010880:Piperidines; D000077208:Remifentanil; D012189:Retrospective Studies; D000077149:Sevoflurane; D014132:Trachea
chemical_list: D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D008738:Methyl Ethers; D010880:Piperidines; D000077149:Sevoflurane; D000077208:Remifentanil