Anesthetic Techniques and Complications for Airway Foreign Body Removal in Children

Theoretical basis: Aspiration of foreign bodies by children is a common problem around the world. Asphyxiation from inhaled foreign bodies is a leading cause of accidental death among children younger than 4 years. The Aim of the study is to determine different anesthetic techniques and complications for airway foreign body removal in children. Results: Most patients with aspirated foreign bodies are children younger than 3 years. Most of the aspirated foreign bodies are organic materials. Nuts (especially peanuts) and seeds (mainly sunflower and watermelon) are the most commonly aspirated foreign bodies reported in almost all studies. A history of a witnessed choking event is highly suggestive of an acute aspiration. Major iatrogenic complications were specified in 21 studies with 9437 children with aspirated foreign bodies. These complications included severe laryngeal edema or bronchospasm, pneumothorax, pneumomediastinum, cardiac arrest, tracheal or bronchial laceration, and hypoxic brain damage. Mortality data were obtained from 26 articles with 43 deaths among 10,236 children (0.42%) with aspirated foreign bodies. Anesthetic considerations encompass preoperative assessment, management techniques for flexible or rigid bronchoscopy, and postbronchoscopic disposition. Conclusion: Aspiration of a foreign body is a potentially lethal event. Although several anesthetic techniques are effective for managing children with foreign body aspiration, there is no consensus from the literature as to which technique is optimal