A dose study of remifentanil in combination with propofol during tracheobronchial foreign body removal in children - 18/05/13
: (Associate Professor), Deniz Karakaya, MD, PhD : (Professor), Ahmet Dilek, MD : (Assistant Professor)Abstract |
Study Objective |
To assess the effect of two different remifentanil infusion doses on hemodynamic stability and recovery characteristics in children undergoing tracheobronchial foreign body removal during rigid bronchoscopy.
Design |
Prospective, randomized, clinical comparison study.
Setting |
Operating room of a university hospital.
Patients |
70 ASA physical status 1 and 2 children, aged 3–12 years, presenting for tracheobronchial foreign body removal during rigid bronchoscopy.
Interventions |
Children were divided equally into two groups to receive either a 0.1 μg/kg/min (Group R1) or 0.2 μg/kg/min (Group R2) remifentanil infusion. Ten minutes after the remifentanil infusion, 3 mg/kg of propofol and 0.02 mg/kg of atropine were given. Anesthesia was maintained with 0.1 μg/kg/min of remifentanil and 100–250 μg/kg/min of propofol in Group R1 and 0.2 μg/kg/min of remifentanil and 100–250 μg/kg/min of propofol in Group R2. After baseline measurements were recorded, 0.2 mg/kg of mivacurium was given intravenously. Ventilation was maintained with 100% O2 via a “T” piece connected to the side arm of the bronchoscope.
Measurements |
Heart rate (HR), systolic (SBP), diastolic (DBP) and mean arterial pressures (MAP), and O2 saturation (SpO2) were recorded before (baseline) and after induction, and 1, 3, 5, 10, 15, 20, 25, and 30 minutes after insertion of the rigid bronchoscope into the trachea. Emergence characteristics and complications were noted. Statistical analysis was performed using independent samples t-test, repeated measures, and chi-square test as appropriate.
Main Results |
Groups were similar in demographics and duration of bronchoscopy and anesthesia (P > 0.05). In Group R1, HR, SBP, DBP, and MAP increased one minute after insertion of the bronchoscope in Group R1 (P < 0.01). Propofol consumption was significantly higher in Group R1 (63.6 ± 30.1 mg) than Group R2 (39.8 ± 26.6 mg; P < 0.01). Time to spontaneous eye opening was 8.6 ± 1.3 minutes in Group R1 and 6.3 ± 1.1 minutes in Group R2 (P < 0.05). The time to recovery to an Aldrete score of 9 was greater in Group R1 (19.8±3.0 min) than Group R2 (16.1±3.0 min; P < 0.01).
Conclusion |
A remifentanil 0.2 μg/kg/min infusion with propofol provides hemodynamic stability and early recovery in children undergoing foreign body removal during rigid bronchoscopy.
Le texte complet de cet article est disponible en PDF.Keywords : Anesthesia pediatric, Bronchoscopy, Foreign body removal, Propofol infusion, Remifentanil infusion
Plan
| ☆ | Supported by Ondokuz Mayis University Research Funding. |
Vol 25 - N° 3
P. 198-201 - mai 2013 Retour au numéro
Article précédent
- Efficacy of facemask ventilation techniques in novice providers
- Neal Stuart Gerstein, Michael Christopher Carey, Darren Alan Braude, Isaac Tawil, Timothy Randal Petersen, Lev Deriy, Mark Spencer Anderson
- How well are prebooked surgical step-down units utilized?
- Serena Shum, Rob Tanzola, Michael McMullen, Wilma M. Hopman, Dale Engen
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?