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

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). 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.