Sedation for short hemato-oncologic invasive procedures in children: comparison of propofol-remifentanil and propofol-fentanyl

J Pediatr Hematol Oncol. 2013 Mar;35(2):112-7. doi: 10.1097/MPH.0b013e318279cbda.

Abstract

Introduction: Short hemato-oncologic procedures are often painful in children, and sedation should be performed outside the operating room.

Aim: : The study aims to compare the effects of remifentanil with those of fentanyl administered during short hemato-oncologic interventions in children.

Materials and methods: A prospective, randomized study was planned for 29 ASA I to III children (aged, 2 to 18 y) to undergo a total of 60 short oncologic interventions. The patients were placed into 2 groups: propofol-remifentanil (group PR) and propofol-fentanyl (group PF). Group PR was first administered propofol (2 mg/kg) and then remifentanil bolus (0.5 μg/kg). Group PF was first administered propofol (2 mg/kg) and then fentanyl bolus (0.5 μg/kg). Systolic arterial pressure, diastolic arterial pressure, mean arterial pressure, respiratory rate, peripheral oxygen saturation, and heart rate were recorded every 3 minutes during the intervention and every 5 minutes after the operation. Postanesthetic recovery scores, eye-opening time to speech, and recovery time were recorded.

Results: Comparison of diastolic arterial pressure in groups at minute 3 of the procedure showed significant difference (P<0.05). Eye-opening to speech (P=0.043) and recovery times (P=0.002) were shorter in group PR.

Conclusions: During short hemato-oncologic interventions in children, the PR combination is a suitable one for early recovery.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Analgesics, Opioid / administration & dosage*
  • Blood Pressure / drug effects
  • Child
  • Child, Preschool
  • Conscious Sedation*
  • Female
  • Fentanyl / administration & dosage*
  • Fentanyl / adverse effects
  • Heart Rate / drug effects
  • Hematologic Neoplasms / diagnosis*
  • Humans
  • Hypnotics and Sedatives / administration & dosage*
  • Male
  • Piperidines / administration & dosage*
  • Piperidines / adverse effects
  • Propofol / administration & dosage*
  • Propofol / adverse effects
  • Prospective Studies
  • Remifentanil
  • Respiration / drug effects

Substances

  • Analgesics, Opioid
  • Hypnotics and Sedatives
  • Piperidines
  • Remifentanil
  • Fentanyl
  • Propofol