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A comparison of fentanyl with tramadol during propofol-based deep sedation for pediatric upper endoscopy

Nurdan Bedirli1, Odul Egritas, Kaan Cosarcan

  • 1Anesthesiology and Reanimation Department, Medical Faculty, Gazi University, Ankara, Turkey. nurbedirli@yahoo.com

Paediatric Anaesthesia
|October 1, 2011
PubMed

Insights

Tramadol offers effective sedation for pediatric upper gastrointestinal endoscopy (UGIE), showing better safety and stability than fentanyl, especially in younger children. This study compared tramadol and fentanyl efficacy and safety in pediatric UGIE.

Area of Science:

  • Pediatric Anesthesiology
  • Gastroenterology
  • Pharmacology

Background:

  • Upper gastrointestinal endoscopy (UGIE) in pediatric patients requires effective sedation.
  • Comparing analgesic and sedative agents is crucial for optimizing procedural safety and patient outcomes.
  • Age-related differences in response to sedatives necessitate tailored approaches.

Purpose of the Study:

  • To compare the efficacy and safety of tramadol versus fentanyl for sedation during pediatric UGIE.
  • To evaluate the impact of patient age on the efficacy and safety of these agents.
  • To assess hemodynamic and respiratory stability, sedation levels, and adverse effects.

Main Methods:

  • Eighty pediatric patients (1-16 years) undergoing UGIE were enrolled.
  • Patients received either fentanyl (2 μg·kg⁻¹) or tramadol (2 mg·kg⁻¹) for sedation.
  • Hemodynamic parameters, oxygen saturation, sedation scores, and adverse events were monitored and analyzed across age subgroups (0-2, 2-12, >12 years).

Main Results:

  • Fentanyl caused significant decreases in oxygen saturation across all age groups compared to baseline.
  • Tramadol resulted in significantly lower sedation scores, fewer adverse effects, and shorter recovery times compared to fentanyl in all age subgroups.
  • Tramadol demonstrated superior hemodynamic and respiratory stability, particularly in younger children.

Conclusions:

  • Tramadol provides sedation efficacy comparable to fentanyl for pediatric UGIE.
  • Tramadol offers improved hemodynamic and respiratory stability and a superior safety profile in pediatric patients undergoing UGIE.
  • Tramadol is a safer and well-tolerated alternative to fentanyl for sedation in younger pediatric patients during UGIE.
Abstract

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