Alid Qayyum M Khalid, Arshad Farzooq, Akhtar Munir, Muhammad Sajid.
Removal of Foreign Body Coin from upper end of Oesophagus: is general anaesthesia always needed?.
Pak J Med Health Sci Jan ;8(2):440-1.

Aims: To evaluate whether removal of foreign body coin from upper esophagus always needs GA or can be safely removed under effect of topical anesthesia and to find quicker ,cost effective and safer method to combat this rapidly increasing pediatric emergency. Methods: This study comprising 138 cases of F.B coin upper end of esophagus presented to ENT department KMU- IMS Teaching Hospital Kohat during January 2010 to April 2013.Patients were aged from 3-7 years. Ninety were males and 48 were females. Removal of coin was tried in all cases after giving topical anesthesia with 2% lignocaine gel using McIntosh laryngoscope and 10 inches long serrated laryngeal forceps. In failed cases of extraction, a short GA was needed for extraction with laryngoscope or small oesophagoscope with same laryngeal forceps or esophageal forceps. Results: Successful removal of coin was conducted under effect of topical anesthesia in 94 cases while 44 cases needed a short GA, of these 44 cases, in 18 cases, coins were removed with laryngoscope and 10 inches long laryngeal serrated forceps while remaining 26 cases needed passage of small oesophagoscope. No bleeding or airway compromise observed during removal under topical anesthesia. Conclusion: Removal of coin from upper esophagus under effect of topical anesthesia is safe, quicker and cost effective.

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