Propofol and remifentanil for deep sedation in children undergoing gastrointestinal endoscopy |
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Authors: | Abu-Shahwan Ibrahim Mack David |
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Affiliation: | Department of Anesthesiology, Children's Hospital of Eastern Ontario, 401 Smyth Rd, University of Ottawa, Ottawa, ON, Canada K1H 8L1. iabushahwan@cheo.on.ca |
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Abstract: | PURPOSE: The aim of this study was to evaluate the safety and efficacy of a combination of propofol and remifentanil deep sedation in spontaneously breathing children less than 7 years of age undergoing upper and/or lower gastrointestinal endoscopy. METHODS: The effect of propofol and remifentanil sedation was prospectively studied in 42 unpremedicated children undergoing gastrointestinal endoscopy. Anesthesia was induced with a combination of sevoflurane, nitrous oxide and oxygen. Anesthesia was maintained with an infusion of propofol (50-80 microg x kg(-1) x min(-1)) and remifentanil (0.1 microg x kg(-1) x min(-1)). Demographic data, heart rate, blood pressure, respiratory rate, and oxygen saturation were recorded every 5 min for each child. In addition, recovery and discharge times were recorded. RESULTS: All 42 procedures were completed with no complications. The combination of propofol and remifentanil resulted in a decrease in heart rate, blood pressure, and respiratory rate. There was no respiratory depression or oxygen desaturation in any child. A bolus of propofol (1 mg x kg(-1)) was necessary in one child for excessive movement. No patient experienced any side effects in the recovery period. CONCLUSION: The combination of propofol and remifentanil for sedation in children undergoing gastrointestinal endoscopy can be considered safe, effective and acceptable. |
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Keywords: | children endoscopy propofol remifentanil sedation |
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