Objective: To explore the effects of propofol target controlled infusion (TCI) plus a low concentration of sevoflurane inhalation induction for the removal of tracheobronchial foreign body in children.
Methods: After the approval of the hospital ethics committee, a total of 90 patients, aged 9 - 36 months old and weighted 8 - 17 kg, were randomly divided into 3 groups: group A, group B and group C. Propofol TCI plus a low concentration of sevoflurane inhalation induction was administered in group A while ketamine or fentanyl plus propofol TCI in group B or C respectively. Effects of anesthesia, complications and recovery durations were observed.
Results: The incidence of severe breathholding and bucking during inserting bronchoscope was 1 case in group A, 7 in group B and 5 in group C. There were significant differences between groups A and B (P < 0.05). The minimal intra-operative SpO2 in group B or group C was lower than that in group A (P < 0.01). The cases for intra-operative SpO2 < 95% in group B or group C were more than that in group A (P < 0.01). And the maximal target concentration of propofol was significantly higher than that in group A (P < 0.01). Ten cases in group B had laryngeal stridor and dyspnea during inspirations post-operatively and occurred more frequently than those in group A or C (P < 0.01). As compared with group A and C, post-operative staying lengths and recovery durations were significantly longer in those in group B (P < 0.01).
Conclusion: Propofol TCI plus a low concentration of sevoflurane inhalation induction is both safe and practical for the controlled removal of tracheobronchial foreign body in children.