Browsing by Author "Ghimire, Basanta"
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Publication Anaesthetic Management of Foreign Body Bronchus: Profile of Cases Appearing at Tribhuvan University Teaching Hospital: An Observational Study(Nepal Medical Association, 2025) Koirala, Megha; Parajuli, Bashu Dev; Joshi, Pankaj; Ghimire, Basanta; Bhattarai, Amit SharmaAbstract Introduction: Rigid bronchoscopy is the preferred method for extracting airway foreign bodies, as it allows grasping forceps to extract foreign bodies while maintaining ventilation through a side port. The main challenge to the Anesthesiologists is to maintain oxygenation and ventilation while sharing the common field with the surgeons. This study intends to evaluate our current practices, challenges, and intraoperative events to enhance patient safety during these procedures. Methods:This is a prospective observational study that included patients with suspected or confirmed bronchial foreign bodies who underwent rigid bronchoscopy from February 2023 to February 2025. Data were collected by the anesthesiologists using the structured proforma, covering the anesthetic technique, complications, and details of foreign bodies. SPSS version 22 was used for analysis. Results: A total of 41 rigid bronchoscopies were performed, including three repeat procedures. Intraoperative complications included desaturation in 29, vocal cord edema in 16, slipping of foreign body in 8, bradycardia and airway bleeding in 6 cases each. Postoperatively, 23 patients required mechanical ventilation, and one patient experienced cardiac arrest. During preoperative preparation, intravenous glycopyrrolate and steroids were used in 38 and 34 cases, respectively. For induction and maintenance, Intravenous anesthesia was the most common technique, with muscle relaxants used in 39 cases. Of the 41 bronchoscopies, 30 achieved successful foreign body removal, while five required thoracotomy referrals. Conclusions: Anesthetic management of rigid bronchoscopy requires careful planning, vigilant monitoring and collaboration. Deasturation is the most frequent complication during removal of a foreign body bronchus.