Removal of esophageal foreign bodies in the pediatric ED: is ketamine an option?

Am J Emerg Med. 2002 Mar;20(2):96-8. doi: 10.1053/ajem.2002.31572.


The objective of the study was to evaluate our experience with esophageal foreign body (EFB) removal comparing the use of ketamine-midazolam (K-M) and fentanyl-midazolam (F-M) in the emergency department (ED), to admission and general anesthesia (GA) in the operating room (OR). A retrospective review of all children undergoing EFB removal at our institution during a 2-year period was conducted. A total of 93 patients were identified: K-M 57/93 (61.2%), F-M 28/93 (30.1%), GA 5/93 (5.4%), and 3/93 (3.2%) by other means. Mean procedure durations were 4.8 min for K-M and 7.0 min for F-M. Mean lengths of stay (LOS) for ED procedures were 3.6 hrs for K-M and 5.7 hrs for F-M, versus 17.7 hrs if admitted. Transient hypoxemia occurred in 10.7% of K-M and 15.4% of F-M. Removal of EFBs in the ED may obviate the need for admission. In our experience, the use of K-M is associated with fewer airway complications, shorter removal times, and an overall shorter LOS.

MeSH terms

  • Anesthesia Department, Hospital
  • Anesthetics, Dissociative*
  • Child, Preschool
  • Conscious Sedation*
  • Emergency Service, Hospital
  • Esophagus*
  • Female
  • Foreign Bodies / surgery*
  • Humans
  • Ketamine*
  • Length of Stay
  • Male


  • Anesthetics, Dissociative
  • Ketamine