Combined propofol and remifentanil intravenous anesthesia for pediatric patients undergoing magnetic resonance imaging

Tsui, Ban C. H.; Wagner, Alese; Usher, Andrew G.; Cave, Dominic; Tang, Cathy

doi:10.1111/j.1460-9592.2005.01462.x

Cited by 40 publications

(45 citation statements)

References 9 publications

(14 reference statements)

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“…There have been many attempts to reduce the incidence of EA by propofol [16,17], fentanyl [18], ketamine [3,4,19], ketolorac [20], nalbuphine [19], etc., but the etiology and preventive treatments of EA are still unclear.…”

Section: Discussionmentioning

confidence: 99%

The effect of ketamine on the incidence of emergence agitation in children undergoing tonsillectomy and adenoidectomy under sevoflurane general anesthesia

Lee

Kim

Choi

et al. 2010

Korean J Anesthesiol

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BackgroundThe rapid emergence and recovery from general anesthesia afforded by sevoflurane is associated with a high incidence of emergence agitation in children. Small doses of ketamine reduce the incidence of emergence agitation. This study compared the effects of ketamine 0.25 mg/kg and 0.5 mg/kg on emergence agitation and postoperative pain.MethodsThe effects of added intravenous ketamine were evaluated in 93 children, ASA I-II, 2-14 years old, undergoing an adenotonsillectomy. The patients were allocated randomly to one of three groups receiving saline (group C), ketamine 0.25 mg/kg (group K0.25) or ketamine 0.5 mg/kg (group K0.5). The children in each group were administered the study drugs 10 minutes before the end of surgery. The recovery characteristics, including the time to extubation, delivery time from the PACU, postoperative nausea and vomiting, agitation and pain were assessed.ResultsThere were no significant differences in the extubation time, delivery time and postoperative nausea and vomiting between the three groups. There were significant differences in modified CHEOPS (Children's Hospital of Eastern Ontario Pain Scale) between the three groups. The incidence of emergence agitation was low in the K0.25 and K0.5 groups compared to the control group. However, there was no significant difference between the K0.25 and K0.5 groups.ConclusionsThere was no significant difference in the incidence of emergence agitation between K0.25 and K0.5 groups. However, K0.5 group showed a lower pain score than K0.25 group.

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Section: Discussionmentioning

confidence: 99%

The effect of ketamine on the incidence of emergence agitation in children undergoing tonsillectomy and adenoidectomy under sevoflurane general anesthesia

Lee

Kim

Choi

et al. 2010

Korean J Anesthesiol

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“…Tsui[4] observed the recovery and discharge times of combined remifentanil and propofol total intravenous anaesthesia in spontaneously breathing children and he found the mean recovery and discharge times were 8.9 and 28.2 min, respectively, and one patient experienced post-procedure nausea and vomiting in his study. The recovery characteristics of two anaesthetic techniques in children undergoing short painful oncology procedures, the discharge readiness from the recovery ward was achieved at 19 min after propofol with remifentanil when compared with the combination of propofol, sevoflurane, and nitrous oxide.…”

Section: Discussionmentioning

confidence: 99%

“…[3] These pharmacokinetic properties could explain the rapid onset and short duration of action of remifentanil. [4]…”

Section: Introductionmentioning

confidence: 99%

Remifentanil infusion as a modality for opioid-based anaesthesia in paediatric practice

2010

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This study was designed to compare the intra-operative and post-operative analgesic requirements and side effects of using fentanyl infusion versus remifentanil infusion during short-duration surgical procedures in children. The study comprised of 40 children randomly allocated into two equal groups: fentanyl (F-group) or remifentanil (R-group). Both were administered a continuous intravenous (i.v.) infusion. Anaesthetic recovery was assessed using the Brussels sedation scale every 5 min from the time of entry till discharge from recovery room. Post-operative analgesia was assessed throughout the first three post-operative (PO) hours using observational pain–discomfort scale (OPS) and adverse events were recorded. Haemodynamic variables showed a non-significant difference between both the groups. Patients who received remifentanil showed significantly shorter time to spontaneous respiration, eye opening, extubation and verbalization compared to those who received fentanyl. Discharge time was significantly shorter in R-group, and 18 patients fulfilled criteria for recovery-room discharge at ≤25 min with a significant difference in favour of remifentanil. Fentanyl provided significantly better PO analgesia than remifentanil and children in F-group showed a significantly lower mean cumulative OPS record than those in R-group; however, the number of patients requiring rescue analgesia did not show a significant difference between both the groups. Two cases in F-group and one in R-group had bradycardia, one case in R-group had mild hypotension and PO vomiting had occurred in three patients in the F-group and two patients in the R-group. In conclusion, remifentanil is appropriate for opioid-based anaesthesia for paediatric patients as it provides haemodynamic stability and rapid recovery with minimal post-operative side effects.

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“…Er werden 16 studies gevonden over propofolsedatie bij MRI-onderzoek (A2 39,46-52 , B1 40,53 , B2 15 , C [54][55][56][57][58] ). In totaal betreft het 6908 procedures, waarvan 5072 afkomstig zijn uit de multicentre studie van Mallory et al 40 Meestal wordt een oplaaddosis (2-3 mg/kg) gevolgd door een getitreerd onderhoudsinfuus (3-15 mg/kg/uur).…”

Section: Propofolunclassified

Succesvolle en veilige sedatie voor MRI-onderzoek bij kinderen

Leroy

Verbeke²,

Nieman

et al. 2011

TIJDSCHR. KINDERGENEESKUNDE

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Combined propofol and remifentanil intravenous anesthesia for pediatric patients undergoing magnetic resonance imaging

Abstract: The combination of remifentanil and propofol for TIVA may be an effective method of light general anesthesia in pediatric patients undergoing MRI.

Cited by 40 publications

References 9 publications

The effect of ketamine on the incidence of emergence agitation in children undergoing tonsillectomy and adenoidectomy under sevoflurane general anesthesia

The effect of ketamine on the incidence of emergence agitation in children undergoing tonsillectomy and adenoidectomy under sevoflurane general anesthesia

Remifentanil infusion as a modality for opioid-based anaesthesia in paediatric practice

Succesvolle en veilige sedatie voor MRI-onderzoek bij kinderen

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