Anesthesia and ventilation for removal of airway foreign bodies in 35 infants

Objective: To explore the safety and effectiveness of modified adapter of Broncho-Cath (TM) Right double lumen tube in removal of tracheobronchial foreign bodies in children. Methods: General anesthesia was induced in 35 children with tracheobronchial foreign bodies. Then a laryngeal mask airway was implanted into each patient, and a modified adapter of Broncho-Cath TM Right double lumen tube was connected for intermittent positive-pressure ventilation. Results: 4, 21 and 10 children suffered from intratracheal foreign body, left main bronchial foreign body and right main endobronchial foreign body, respectively. Bronchofiberscope implantation was satisfactorily achieved in 32 children (91%), and success in bronchofiberscope was successfully implanted after adjustment in 3 children (9%). Compared to T-0, HR decreased at T-1 (P < 0.05) and significantly reduced at T-2, T-3 and T-4 (P < 0.01). MAP increased at T-1 and declined at T-3 (P < 0.05). PaO2 rose significantly at T-1 similar to T-5 (P < 0.01), and there were no statistical differences in PaCO2 at different time points. Compared to ASA II patients, the incidences of severe hypoxemia, hypertension or hypotension were all higher, and the awakening time was longer in ASA III or IV patients (P < 0.05), and the bronchoscopy time was longer and the incidence of arrhythmia was significantly higher (P < 0.01). Conclusion: In removal of tracheobronchial foreign bodies in children, appropriately modified Broncho-Cath (TM) Right adapter and laryngeal mask airway after intravenous anesthesia for breathing control can improve the ventilation function and perioperative safety. Thereby, it is worthy of clinical application.