Anesthesia of the extraction of foreign bodies from the upper airways:
Anesthetic procedures for the extraction of foreign bodies inhaled

Kalouch S* ; Yakini K.Elaiassi M ; Chlilek A
Page No. 31-42

Inhalation of foreign body is a major cause of death by domestic accidents among children, mostly
among those under three years old. Asphyxia is the main immediate risk. Respiratory effects may
occur if the extraction time is extended .the seriousness of this incident has been significantly
reduced due to advances in instrumentation and anesthesia. The prupose of this study was to
investigate the epidemiological criteria, clinical, paraclinical, therapeutic, and anesthetic
procedures for the extraction of foreign bodies inhaled at the University Hospital of Children
ABDERRAHIM Harouchi in Casablanca. This is a retrospective study in Pediatric Resuscitation
service during the years 2015-2016 , and which permitted the recruitment of 42 cases of foreign
body extracts under general anesthesia, let an incidence equal to 3,66%. The foreign body of the
airways was frequent between 6 months and 3 years old children (73,80%). The diagnosis was
based on the research of penetration syndrome that was present in 88,09% of the cases. The thorax
radiography was normal in 50% of the cases and the foreign body was radio-opaque in 11,90% of
the cases. The choice treatment was the extraction of the foreign body by rigid bronchoscopy under
general anesthesia although it is as difficult and risky one. The operation may know severe
complications: hypoxemia by hypoventilation, laryngospasm, bronchospasm and disorders of
cardiac rhythm in particular, that the anesthesia is partially the origin.Accurate preoperative
evaluation of the patient was necessary. The anesthesic management was classic that the best is the
use of intravenous products with short delay and duration of action (Propofol, succinylcholine).The
ventilation was manually assisted for all the patients. A careful respiratory supervision during the
waking up was obligatory. The nature of the foreign body was dominated by peanuts (32,6%) with
predominance of bronchial localization (71,74%). Finally, we must insist on the diagnosis and the
precocious extraction of a foreign body in order to avoid in the long term aftereffects. We must also
reinforce the prevention and the education of the parents, by training them into Heimlich’s exercise,
to ensure proper vigilance and obviously a reduction in the incidence of this serious accident.
Keywords: Anesthesia-airways-foreign body-respiratory distress of the child.