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Higher doses of fentanyl during bronchoscopy in infants significantly reduces perioperative complication rates

Marinov Ts1, M Belitova1, T M Popov2

  • 1Department of Anesthesiology and Intensive Care, Medical University-Sofia, Sofia, Bulgaria.

International Journal of Pediatric Otorhinolaryngology
|November 6, 2020
PubMed

Insights

Higher fentanyl doses during infant rigid bronchoscopy significantly reduced perioperative complications like bronchospasm and laryngospasm. This refinement improves intraoperative hemodynamics without new risks.

Area of Science:

  • Anesthesiology
  • Pediatric Surgery
  • Otolaryngology

Background:

  • Rigid bronchoscopy is a common procedure for foreign body removal in infants.
  • Anesthesia management for rigid bronchoscopy in infants aims to minimize hemodynamic instability and complications.
  • Current anesthetic protocols may not fully optimize outcomes for this vulnerable population.

Purpose of the Study:

  • To evaluate the impact of higher fentanyl doses on perioperative complication rates in infants undergoing rigid bronchoscopy.
  • To assess the effect of increased fentanyl administration on intraoperative hemodynamic parameters.

Main Methods:

  • A prospective cohort study involving 60 infants undergoing rigid bronchoscopy for foreign body removal.
  • Random assignment of infants into two groups: lower fentanyl dose (1-2 μg/kg) and higher fentanyl dose (6-7 μg/kg).
  • Monitoring and recording of hemodynamic parameters and perioperative complications.

Main Results:

  • Infants receiving higher fentanyl doses exhibited significantly lower heart rate, systolic, and diastolic blood pressure post-intubation and post-extubation compared to the lower dose group.
  • Bronchospasm and laryngospasm were significantly more frequent in the lower fentanyl dose group (p=0.020).
  • The association between lower fentanyl dose and increased complications showed moderate strength (V=0.302).

Conclusions:

  • Higher doses of fentanyl during rigid bronchoscopy in infants are associated with reduced perioperative complications.
  • Increased fentanyl administration improves intraoperative hemodynamics in this pediatric population.
  • Refinement of anesthetic protocols with higher fentanyl doses is proposed for safer infant rigid bronchoscopy.
Abstract

Keywords:
BronchoscopyBronchospasmComplicationsFentanylForeign bodiesLaryngospasm

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