Tracheobronchial Foreign Bodies In Nierian Children: Clinical Profile And A Teachnique Of Administering Anaesthesia During Rigid Bronchoscopic Removal
AbstractAim: To highlight the clinical profile of foreign body aspiration in children seen in a clinic in Enugu and the technique of rigid bronchoscopic removal of these foreign bodies under general anaesthesia.
Method: The study was retrospective. The anaesthetic pre-medication was to give intravenous atropine 0.01mg/kg body weight. Anaesthesia was induced wih intravenous dose of ketamine 2.0mg/kg and midazolam 0.1mg/kg body weight, and followed with a bolus dose of suxamethonum 1mg/kg. An appropriate sized rigid respiratory bronchoscope assembly was inserted into the trachea. Patient was ventilated manually and bronchoscopic removal of foreign body done.
Results: They were 19 males and 11 females, with an average age of 1.6years. Groundnut was the most commonly recovered foreign body in 19(63%) patients. The right main bronchus was the commonest site of impaction in 10(33%) patients. No foreign body was recovered in 4(13.3%) patients. Two patients (6.6%) died from severe acute pulmonary oedema.
Conclusion: Foreign body aspiration is a persistent life-threatening problem among Nigerian children. We recommend that children below the age of 4 years should not be fed whole groundnuts.
Key words: Anesthesia, Foreign body aspiration, Tracheo-bronchial tree.
(J College Med: 2003 8(1): 27-29)