Use of a remifentanil–propofol mixture for pediatric flexible fiberoptic bronchoscopy sedation

Berkenbosch, John W.; Graff, Gavin R.; Stark, James M.; Ner, Zarah; Tobias, Joseph D.

doi:10.1111/j.1460-9592.2004.01355.x

Cited by 102 publications

(70 citation statements)

References 14 publications

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“…Its pharmacological mechanism is not entirely clear yet, however, it seems to activate the caminobutyric A receptor-chloride ionophore complex [16]. Its rapid onset of action and amnesic properties, coupled with smooth and rapid recovery, make propofol an appealing agent for procedural sedation [11,17,18]. The significant advantage of a faster recovery time compared with other sedatives has been emphasised in several studies [19][20][21][22].…”

mentioning

confidence: 99%

Propofolversuspropofol plus hydrocodone for flexible bronchoscopy: a randomised study

Schlatter¹,

Pflimlin²,

Fehrke³

et al. 2011

Eur Respir J

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Propofol and the combination of a benzodiazepine and an opiate have been established for sedation in flexible bronchoscopy. It is as yet unknown whether propofol in combination with an opiate is superior to propofol alone to suppress cough during the procedure. 300 consecutive patients undergoing flexible bronchoscopy at a tertiary care university hospital were randomly allocated to receive either the combination propofol and hydrocodone or propofol alone in a double-blind fashion. The primary end-point was the cough score during the procedure as estimated by the physician using a visual analogue scale.Demographics were similar in both groups. Compared with propofol alone, median (interquartile range) cough scores assessed by physicians, nurses and patients were significantly lower in the group randomised to the combination propofol and hydrocodone (2.5 (1.5-4.0) versus 2.0 (1.0-3.0), respectively, p50.011). Additionally, patients receiving the combination required significantly lower doses of propofol than those receiving propofol alone (200 mg (140-280) versus 260 mg (180-350), p,0.0001). Complex examinations, including bronchoalveolar lavage or transbronchial biopsy, benefited more from additional opiate. The duration of the procedure, time to discharge and complication rate were similar in both groups.The combination of propofol and hydrocodone is safe and superior to propofol alone for cough suppression in flexible bronchoscopy.

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mentioning

confidence: 99%

Propofolversuspropofol plus hydrocodone for flexible bronchoscopy: a randomised study

Schlatter¹,

Pflimlin²,

Fehrke³

et al. 2011

Eur Respir J

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“…Remifentanil is a 4-anilidopiperidine derivative of fentanyl. Unlike other opioids, it is rapidly metabolized by hydrolysis by nonspecific blood and tissue esterases [16,17]. Meperidine is an opioid pain medication.…”

Section: Drugsmentioning

confidence: 99%

Sedation for Pediatric Patient with End-Stage Hepatic Disease Outside Operating Room

Çankaya¹

2017

J Gastrointest Dig Syst

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Sedation outside operating room for children has increasing importance. Pediatric patients with end stage liver disease are of great importance for various and frequent procedures including gastrointestinal endoscopy, magnetic resonance imaging, computerized tomography, brachytherapy, catheterisation, interventional radiology. Anesthesia plan plays critical role for the success of these procedures. Patient safety, ventilation, hemodynamic responses, side effects of anesthetics on liver and periprocedural analgesia are the main topics of attention. Airway management tools may be helpful because of edema and ascites pushing diaphragm upwards. Nasal capnography enables monitoring spontaneous ventilation. Enlargement of extravascular extracellular fluid and dysproteinemia, effects drug behaviors. Drug elimination half-time as well as context sensitive half-time have to be taken into account and designed individually. The pressure above vena cava inferior, results with decrease in preload, thus reduction in cardiac output. Pulse wave variation monitoring helps for estimating circulating fluid status. Tendency for bleeding can be anticipated with fresh frozen plasma. Patient-controlled analgesia may be a choice of favor but close monitoring required for repeated analgesics. Children's Hospital of Eastern Ontario Pain Scale would be a good monitoring tool for pain.

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“…Remifentanil analjezik etkisi fentanile benzer olup, yararı infüzyonun kesilmesiyle etkisinin devam etmemesi ve hepatik disfonksiyonu olan hastada ilaç birikiminin gözlenmemesidir. Berkenbosch ve arkadaşlarının yaptığı çalışmada, FOB için remifentanil propofol ile kombine infantlarda güvenle uygulanmış ancak diğer opiyatlar ile karşılaştırmalı çalışmala-ra ihtiyaç olduğu vurgulanmıştır (18).…”

Section: Opiyatlarunclassified

Sedation for fiberoptic bronchoscopy: review of the literature

Talay¹,

Kargi²,

Yaşar³

et al. 2015

Tuberk Toraks

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Use of a remifentanil–propofol mixture for pediatric flexible fiberoptic bronchoscopy sedation

Abstract: A remifentanil/propofol mixture provided effective sedation and rapid recovery in pediatric patients undergoing fiberoptic bronchoscopy.

Cited by 102 publications

References 14 publications

Propofolversuspropofol plus hydrocodone for flexible bronchoscopy: a randomised study

Propofolversuspropofol plus hydrocodone for flexible bronchoscopy: a randomised study

Sedation for Pediatric Patient with End-Stage Hepatic Disease Outside Operating Room

Sedation for fiberoptic bronchoscopy: review of the literature

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