From the Department of Anesthesiology, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado.
Department of Otolaryngology-Head and Neck Surgery, Nationwide Children's Hospital and Wexner Medical Center at Ohio State University, Columbus, Ohio.
Anesth Analg. 2020 Mar;130(3):665-672. doi: 10.1213/ANE.0000000000004029.
Button battery ingestions result in significant morbidity and mortality in children-before, during, and even after removal. The injuries created by a button battery lodged in the esophagus develop rapidly and can be severe. The current of the button battery, conducted through saliva and the tissue drives a highly alkaline caustic injury, leading to liquefactive tissue necrosis. In June 2018, new guidelines were released from the National Capital Poison Center, which include the use of preoperative protective, pH-neutralizing and viscous barrier interventions with honey and/or sucralfate administered within 12 h of ingestion. In addition, the use of postremoval irrigation of the esophagus with 50-150 mL 0.25% acetic acid is done in the operating room to help neutralize the site of tissue injury. Given that anesthesiologists play an important role in the management of esophageal foreign body removal, the entire specialty needs to be aware of the supporting data behind this and general perioperative considerations for management and potential complications of button battery ingestion.
纽扣电池的摄入会导致儿童严重的发病率和死亡率——在摄入之前、期间甚至之后。纽扣电池卡在食道中会迅速造成严重的损伤。纽扣电池的电流通过唾液和组织传导，导致高度碱性腐蚀性损伤，导致液化性组织坏死。2018 年 6 月，国家首都毒物中心发布了新的指南，其中包括在摄入后 12 小时内使用术前保护、中和 pH 值、粘性屏障干预措施，使用蜂蜜和/或硫糖铝。此外，在手术室中还使用 50-150 毫升 0.25%的醋酸进行食管清除后的冲洗，以帮助中和组织损伤部位。鉴于麻醉师在食管异物取出的管理中起着重要作用，整个专业都需要了解这方面的支持数据，以及管理纽扣电池摄入的一般围手术期注意事项和潜在并发症。
