Foreign body in the tracheobronchial tree is serious and, on occasion, fatal. The symptoms and signs can be confused with asthma and pneumonia, leaving the true condition unsuspected. Children one to three years old with a triad of cough, wheezing and decreased air entry should be suspected. A child with protracted pneumonia should be reconsidered. Chest films in the expiratory phase should be taken. In no other operative procedure is it more important to have teamwork and good communication between endoscopist and anesthesiologist, when the diagnosis is made.
Currently available anesthetic techniques for laryngoscopy and bronchoscopy are briefly evaluated. Recently reported complications from the literature are reviewed. Satisfactory anesthetic techniques are shown to be limited by the physical dimensions of the instruments as well as the extreme limitations of the flow capacity of the small airway itself. The technique used at the Hospital for Sick Children for the past ten years is described. It is based upon spontaneous respiration with inhalation anesthesia, supplemented by topical lidocaine (Xylocaine). Size and age of the patient are not limiting factors. The safety and effectiveness of this technique are supported by representative blood gas studies as well as the clinical records of over 400 cases.
ANAESTHETIC AGENTS can cause acute "z and chronic 3"4 illness in operating-room personnel and contribute to atmospheric pollution in hospltals. 9 Several professionaP -s and national ~s bodies have proposed guidelines concerning this problem.
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