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Sedation for Short Hemato-Oncologic Invasive Procedures in Children: Comparison of Propofol-Remifentanil and Propofol-Fentanyl

Ince, Icten E. MD; İyilikci, Leyla MD; Yilmaz, Şebnem MD; Güneş, Dilek MD; Akkuş, Muhammed MD; İsguven, Duyguhan MD

Journal of Pediatric Hematology/Oncology: March 2013 - Volume 35 - Issue 2 - p 112–117
doi: 10.1097/MPH.0b013e318279cbda
Original Articles

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.

Departments of *Anesthesiology and Intensive Care

Pediatric Hematology

Pediatric Oncology, School of Medicine, Dokuz Eylül University, İzmir, Turkey

Supported by the Department of Anesthesiology and Reanimation and I.E.I.

I.E.I. and L.İ.: designed the study and wrote the protocol. Ş.Y., D.G., M.A., and D.İ.: managed the literature searches, data collection, data interpretation, and undertook the statistical analysis. I.E.I. and L.İ.: wrote the first draft of the manuscript. I.E.I., L.İ, Ş.Y., D.G., M.A., and D.İ. have contributed and have approved the final manuscript.

The authors declare no conflict of interest.

Reprints: Leyla İyilikci, MD, Department of Anesthesiology and Intensive Care, School of Medicine, Dokuz Eylül University, İnciralti 35340, İzmir, Turkey (e-mail: leyla.iyilikci@deu.edu.tr).

Received November 29, 2011

Accepted October 17, 2012

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