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Sedation for bronchoscopy in children: A prospective randomized double-blinded trial

Eva Tschiedel1, Maximilian Eckerland2, Ursula Felderhoff-Mueser1

  • 1Department of Pediatrics I, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.

Pediatric Pulmonology
|December 18, 2020
PubMed

Insights

Adding remifentanil to propofol deep sedation for pediatric flexible bronchoscopy significantly reduced coughing and recovery time. This combination offers a potentially improved sedation strategy for children undergoing this procedure.

Area of Science:

  • Pediatric Anesthesiology
  • Respiratory Medicine
  • Procedural Sedation

Background:

  • Flexible bronchoscopy in children necessitates deep sedation.
  • Current sedation regimens vary, with some incorporating opioids.
  • Opioids' antitussive properties may benefit bronchoscopy, but respiratory depression is a concern.

Purpose of the Study:

  • To systematically compare sedation regimens for pediatric flexible bronchoscopy.
  • To evaluate the efficacy and safety of propofol alone versus propofol with remifentanil.

Main Methods:

  • A randomized study involving 50 pediatric patients (aged 1-17 years) undergoing flexible bronchoscopy.
  • Patients received either propofol alone (PP group) or propofol with remifentanil (PR group).
  • Sedation depth was standardized using the Comfort Score (10-13).

Main Results:

  • The propofol-remifentanil group (PR) showed significantly fewer coughing episodes per minute compared to propofol alone (PP).
  • Group PR also experienced significantly shorter recovery times post-procedure.
  • Examiner satisfaction was higher in the PR group, while adverse events and patient satisfaction did not differ.

Conclusions:

  • The combination of propofol and remifentanil is suggested as a superior sedation strategy for pediatric flexible bronchoscopy.
  • This approach may enhance procedural comfort by reducing coughing and speeding recovery.
  • Further research could explore optimal dosing and long-term outcomes.
Abstract

Keywords:
bronchoscopychildpropofolremifentanilsedation

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