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

Authors: RAUF GÜL, ŞAMİL HIZLI, BETÜL KOCAMER, SENEM KORUK, LEVENT ŞAHİN, HÜSEYİN KILINÇASLAN, VAHAP SARIÇİÇEK

Abstract: 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.

Keywords: Anesthesia, pediatric, remifentanil, fentanyl, upper gastric endoscopy

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