Keil Oliver, Schwerk Nicolaus
Clinic of Anesthesiology and Intensive Care Medicine.
Clinic of Pediatric Pulmonology, Allergology and Neonatology, Hannover Medical School.
Curr Opin Anaesthesiol. 2023 Jun 1;36(3):334-339. doi: 10.1097/ACO.0000000000001251. Epub 2023 Jan 30.
Anesthesia for foreign body removal in children can be quite challenging. Even though rigid bronchoscopy is considered the gold standard for foreign body removal, there is increasing evidence for successful foreign body removal using flexible bronchoscopy. This review discusses the recent implications for flexible bronchoscopy for the purpose of foreign body removal and will compare these findings to rigid bronchoscopy.
During the last few years, several observational studies on foreign body removal by flexible bronchoscopy have been published, with promising results.
Flexible bronchoscopy is a feasible and safe method for removing aspirated foreign bodies in children. In order to improve patient safety during the procedure, it is necessary for a pediatric anesthetist and a pediatric pulmonologist to work closely together. The anesthetist can take care of the administration of the anesthetic and maintenance of the vital functions, and the pulmonologist can carry out a safe and fast bronchoscopy. In the case of foreign body removal by flexible bronchoscopy, the anesthesiological procedure of choice should be general anesthesia with controlled ventilation via a laryngeal mask.
小儿异物取出术的麻醉颇具挑战性。尽管硬质支气管镜检查被视为异物取出的金标准,但越来越多的证据表明,使用柔性支气管镜检查成功取出异物也是可行的。本综述讨论了柔性支气管镜检查在异物取出方面的最新意义,并将这些结果与硬质支气管镜检查进行比较。
在过去几年中,已经发表了几项关于使用柔性支气管镜检查取出异物的观察性研究,结果令人鼓舞。
柔性支气管镜检查是一种可行且安全的方法,用于取出儿童误吸的异物。为了提高手术过程中的患者安全性,小儿麻醉医生和小儿肺科医生必须密切合作。麻醉医生可以负责麻醉给药和维持生命功能,肺科医生可以进行安全、快速的支气管镜检查。在使用柔性支气管镜检查取出异物的情况下,首选的麻醉方法应该是通过喉罩进行控制通气的全身麻醉。