Discovery of hazardous foreign bodies observed during anesthetic practice

Abstract

Background: In anesthesia practice, obstructing materials like thick mucus secretion, debris or blood clots, and food particles accumulate in the oropharynx. If not properly removed, they could cause airway obstruction with concurrent hypoxia which may end fatally. Objectives: This study aims to highlight the importance of forgetting foreign objects in the airway in order to allert anesthesiologists about the hazards of missed foreign bodies in the oropharynx which could lead to disastrous situation. Patients and Methods: During the period from 2012-2014, out of 2300 patients presented for surgical operation under general anesthesia with endo-tracheal intubation, 22 patients were recorded to have accidental discovery of hazardous foreign bodies retained in the oropharynx and were included in this study with an incidence rate of 0.96%. Cases in this study were classified as patient-related or surgery-related. Foreign bodies were identified with the aid of laryngoscopy and were removed by suction hand piece or Magill's forceps. Results: The main age group was between 21-40 years accounting for 45.5%. Male: female ratio was 1.2:1. Overall, 59.1% were related to patients' causes, while 40.9% were related to surgery. The commonest type of foreign body observed was cardamom (38.5%) among patient-related cases, and tissue remnants in 66.7% of surgery-related cases. Conclusion: Missed foreign bodies are not uncommon and anesthesiologists should be aware of inspecting the mouth and throat of the patient thoroughly before endotracheal intubation and extubation to reduce the hazard of foreign body inhalation.

Keywords

• foreign bodies
• anesthetic practice