The safety and efficacy of remifentanil compared to fentanyl in pediatric endoscopy

To compare propofol combinations with low induction doses of remifentanil and fentanyl in respect to the complication frequency and efficiency in ease of procedure in children undergoing esophagogastroduodenoscopy. Materials and methods: Sixty-four patients, aged 3-14 years and undergoing elective esophagogastroduodenoscopy, were included in the study. The patients received an induction dose of 0.25 µg kg-1 remifentanil and 2 mg kg-1 propofol (group R), or 0.5 µg kg-1 fentanyl and 2 mg kg-1 propofol (group F) before the procedure. The procedure began with a sedation score of >=5. Hemodynamic values, movement, ease and duration of the procedure, the time to awakening, and any requirement for additional doses of propofol/opioids and adverse events were recorded. Results: Although frequency of apnea after induction was higher and the duration of apnea was longer in group R, during procedure and postprocedure follow-up, there were no apnea episodes in either group (P < 0.05, P > 0.05). Intraoperative respiratory rate, time to eye opening, opioid consumption, and duration of recovery were significantly shorter in group R (P < 0.05). Conclusion: Remifentanil, when combined with propofol, can provide as efficient and safe anesthesia as fentanyl propofol combination for procedures like esophagogastroduodenoscopy.

The safety and efficacy of remifentanil compared to fentanyl in pediatric endoscopy

To compare propofol combinations with low induction doses of remifentanil and fentanyl in respect to the complication frequency and efficiency in ease of procedure in children undergoing esophagogastroduodenoscopy. Materials and methods: Sixty-four patients, aged 3-14 years and undergoing elective esophagogastroduodenoscopy, were included in the study. The patients received an induction dose of 0.25 µg kg-1 remifentanil and 2 mg kg-1 propofol (group R), or 0.5 µg kg-1 fentanyl and 2 mg kg-1 propofol (group F) before the procedure. The procedure began with a sedation score of >=5. Hemodynamic values, movement, ease and duration of the procedure, the time to awakening, and any requirement for additional doses of propofol/opioids and adverse events were recorded. Results: Although frequency of apnea after induction was higher and the duration of apnea was longer in group R, during procedure and postprocedure follow-up, there were no apnea episodes in either group (P < 0.05, P > 0.05). Intraoperative respiratory rate, time to eye opening, opioid consumption, and duration of recovery were significantly shorter in group R (P < 0.05). Conclusion: Remifentanil, when combined with propofol, can provide as efficient and safe anesthesia as fentanyl propofol combination for procedures like esophagogastroduodenoscopy.

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  • Dilos BM. Anesthesia for pediatric airway endoscopy and upper gastrointestinal endoscopy. Int Anesthesiol Clin 2009; 47: 55–62.
  • Disma N, Astuto M, Rizzo G, Rosano G, Naso P, Aprile G et al. Propofol sedation with fentanyl or midazolam during oesophagogastroduodenoscopy in children. Eur J Anaest 2005; 22: 848–52.
  • Tolia V, Peters JM, Gilger MA. Sedation for pediatric endoscopic procedures. J Pediatr Gastroenterol Nutr 2000; 30: 477–85.
  • Tesniere A, Servin F. Intravenous techniques in ambulatory anesthesia. Anesth Clin N Am 2003: 21; 273–88.
  • Elitsur Y, Blankenship P, Lawrence Z. Propofol sedation for endoscopic procedures in children. Endoscopy 2000; 32: 788– 91.
  • Tosun Z, Aksu R, Guler G, Esmaoglu A, Akin A, Aslan D et al. Propofol-ketamine vs propofol-fentanyl for sedation during pediatric upper gastrointestinal endoscopy. Paediatr Anaesth 2007; 17: 983–88.
  • Abu-Shahwan I, Mack D. Propofol and remifentanil for deep sedation in children undergoing gastrointestinal endoscopy. Paediatr Anaesth 2007; 17: 460–63
  • Berkenbosch JW, Graff GR, Stark JM, Ner Z, Tobias JD. Use of a remifentanil-propofol mixture for pediatric flexible fiberoptic bronchoscopy sedation. Paediatr Anaesth 2004; 14: 941–46.
  • Niksch A, Liberman L, Clapcich A, Schwarzenberger JC, Silver ES, Pass RH. Effects of remifentanil anesthesia on cardiac electrophysiologic properties in children undergoing catheter ablation of supraventricular tachycardia. Pediatr Cardiol 2010; 31: 1079–82.
  • Foubert L,  Reyntjens K,  De Wolf D,  Suys B,  Moerman A, Mortier E. Remifentanil infusion for cardiac catheterization in children with congenital heart disease. Acta Anaesthesiol Scand 2002; 46: 355–60.
  • But A, Arıkan M, Aslan B, Öztürk L, Tabuk M, Eyüp Horasanlı E. Comparison of anesthesia with sevoflurane-N2O and midazolam-remifentanil in low-birth-weight premature infants undergoing diode laser photocoagulation. Turk J Med Sci 2012; 42: 573–9.
  • Uzun Ş, Özkaya BA, Yılbaş ÖS, Ayhan B, Şahin A, Aypar Ü. Effects of different propofol injection speeds on blood pressure, dose, and time of induction. Turk J Med Sci 2011; 41: 397–401.
  • Barone CP, Pablo CS, Barone GW. Postanesthetic care in the critical care unit. Crit Care Nurse 2004; 24: 38–45.
  • Ceylan G, Yavaşcaoğlu B, Korfalı G, Kaya FN, Başağan Moğol E, Türker G. A comparison of propofol and dexmedetomidine on the effects of heamodynamy and cognitive functions in conscious sedation during endoscopic retrograde cholangiopancreatography. J Uludağ Univ Med Faculty 2010; 36: 103–10 (in Turkish with English abstract).
  • Hassall E. Should pediatric gastroenterologists be i.v. drug users? J Pediatr Gastroenterol Nutr 1993; 16: 370–2.
Turkish Journal of Medical Sciences-Cover
  • ISSN: 1300-0144
  • Yayın Aralığı: 6
  • Yayıncı: TÜBİTAK
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