Total Intravenous Anesthesia and Spontaneous Ventilation for Foreign Body Removal in Children

2010 ◽  
Vol 111 (6) ◽  
pp. 1566 ◽  
Author(s):  
Stephan Malherbe ◽  
J. Mark Ansermino
Author(s):  
Weiping wang ◽  
Shangyingying Li ◽  
Hui Liu ◽  
Qin Tian ◽  
Hang Chen ◽  
...  

Background: There is no consensus regarding the optimal anesthetic approach to rigid bronchoscopy in children suffering from tracheobronchial FBA. We performed this meta-analysis to assess the efficacy and safety of the different anesthesia agents and ventilation modes for tracheobronchial foreign body removal via rigid bronchoscopy in young children. Methods: A systematic search of three major databases for all relevant articles. A meta-analysis was performed to analyze the data. Results: Four trials for evaluating different anesthetics and six trials for evaluating two kinds of ventilation modes were found. Compared with the sevoflurane-based volatile anesthesia group , the rate of perioperative complications included hypoxemia (OR, 2.07; 95% CI, 1.38–3.11; P=0.0004; I2 = 0%), apnea (OR, 2.74; 95% CI, 1.11–6.78; P = 0.03; I2 = 60%), laryngospasm (OR, 2.89; 95% CI, 1.67–4.98; P=0.0001; I2 = 0%), cough/bucking (OR, 2.93; 95% CI, 1.86–4.63; P<0.00001; I2 = 0%), and body movement (OR, 3.51; 95% CI, 2.03–6.09; P<0.00001; I2 = 0%) were significantly increased in the propofol-based total intravenous anesthesia and the duration of operation were longer in the Group Prop. Compared with the control ventilation group , the incidences of laryngospasm (OR, 0.16; 95% CI, 0.05–0.56; P=0.004; I2 = 54%), apnea (OR, 0.21; 95% CI, 0.09–0.50; P=0.0004; I2 = 0%), and cough/bucking (OR, 0.03; 95% CI, 0.01–0.10; P<0.00001; I2 = 41%) increased in the spontaneous ventilation group and the duration of operationand emergence from anesthesia significantly prolonged in the Group SV. Conclusions: Our meta-analysis suggests that sevoflurane-based volatile anesthesia was superior to propofol-based total intravenous anesthesia for the management of foreign body aspiration in children. There is still no strong evidence indicated that one ventilation technique was superio


Author(s):  
Astha Agrawal Kanaparthi ◽  
Vikas Nair ◽  
Pramod Kale ◽  
Arvind Kate

Introduction: Bronchoscopy is performed for diagnostic and therapeutic purposes. It is a challenge for the anaesthesiologist to maintain ventilation for the patient as the patients’ airway is shared between the anaesthetist and the bronchoscopist. Many modalities have been used for anaesthesia and airway management for bronchoscopies. We present a case of bronchoscopy guided foreign body removal under anaesthesia. Spontaneous ventilation was maintained in the patient with the help of nasal airways. Keywords: Bronchoscopy, Ventilation, Nasal airway.


Skull Base ◽  
2007 ◽  
Vol 17 (S 1) ◽  
Author(s):  
Stanislaw Kwiek ◽  
Hanna Doleżych ◽  
Wojciech Ślusarczyk ◽  
Piotr Bażowski ◽  
Izabela Duda ◽  
...  

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