Propofol and remifentanil for deep sedation in children undergoing gastrointestinal endoscopy

Abstract

The combination of propofol and remifentanil for sedation in children undergoing gastrointestinal endoscopy can be considered safe, effective and acceptable.

¿Existe un valor de índice biespectral adecuado para endoscopias digestivas altas en respiración espontánea en el paciente pediátrico?

“…Al diseñar el estudio se descartó la población menor de 12 meses, pues el índice BIS no está suficientemente validado en los lactantes 12 . Se eligió el propofol como fármaco a administrar en el protocolo, pues es muy usado en procedimientos invasivos en pediatría 3,7,9,13 ; administrado de forma correcta en la inducción, se evita el riesgo de apnea 10 . Se sabe que durante el estado de hipnosis están abolidas todas las respuestas motoras del paciente al estímulo y existe frecuentemente compromiso de permeabilidad de vía aérea.…”

Anesthesia and sedation in pediatric gastrointestinal endoscopic procedures: A review

“…A combination of remifentanil and propofol is considered safe, effective and acceptable for sedation in children under going gastrointestinal endoscopy [21] . However, the authors recommend the use of this combination by an experienced anesthesiologist in a hospital setting, as the combination may result in apnea and the need to control the airway.…”

“…The time to peak effect is 90-100 sec after a dose of 2. [21] . The authors recommend this combination for sedation in children in a hospital setting in presence of an anesthesiologist.…”

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

“…Different combinations of these agents were studied in pediatric anesthesia literature (2,8,10,11). Fentanyl is a frequently used opioid agent proven to be efficient and safe for pediatric procedures, but its potency is intermediate and blood clearance is slow, which usually leads to much longer anesthesia duration than that of endoscopic procedures (2,8,10,11).…”

“…Different combinations of these agents were studied in pediatric anesthesia literature (2,8,10,11). Fentanyl is a frequently used opioid agent proven to be efficient and safe for pediatric procedures, but its potency is intermediate and blood clearance is slow, which usually leads to much longer anesthesia duration than that of endoscopic procedures (2,8,10,11). Remifentanil, which is a more potent agent with shorter duration of action, is frequently used in pediatric outpatient anesthesia in bone marrow aspiration, bronchoscopy, and cardiac catheterization, as well as in laser photocoagulation in premature infants (12)(13)(14)(15).…”