[Removal of a bronchial foreign body in a child using the laryngeal mask]

The laryngeal mask (LM) was employed for the removal of a bronchial foreign body (screw) in a 2-year-old boy weighing 16 kg since the 6.0 mm external diameter fiberoptic bronchoscope (FBS) for extraction forceps could not be used under tracheal intubation. Anesthesia was induced with sevoflurane in 100% oxygen. After injection of fentanyl 25 micrograms and vecuronium 2 mg, a gastric tube and a size 2 LM were inserted. Throughout the extraction procedure by the FBS in the left main bronchus, the boy had one lung ventilated manually. The airway pressure was kept under 15 cmH2O to avoid gas leakage around the cuff and gastric inflation. Oxygen saturation of 100% with pulse oximetry and PETCO2 of 35 to 45 mmHg with capnometry were maintained. The foreign body was extracted by biopsy forceps. A Fogarty catheter was not effective because the balloon tip was broken by the screw. The LM does not prevent regurgitation and does not provide adequate ventilation under increased airway pressure, but it facilitates the use of a larger size FBS equipped with a variety of extraction forceps. Therefore, it seems to be a useful device for the removal of bronchial foreign bodies in children.