Propofol and remifentanil for deep sedation in children undergoing gastrointestinal endoscopy.
OBJECTIVE
The aim of this study was to evaluate the safety and efficacy of a combination of propofol and remifentanil deep sedation in spontaneously breathing children less than 7 years of age undergoing upper and/or lower gastrointestinal endoscopy.


METHODS
The effect of propofol and remifentanil sedation was prospectively studied in 42 unpremedicated children undergoing gastrointestinal endoscopy. Anesthesia was induced with a combination of sevoflurane, nitrous oxide and oxygen. Anesthesia was maintained with an infusion of propofol (50-80 microg x kg(-1) x min(-1)) and remifentanil (0.1 microg x kg(-1) x min(-1)). Demographic data, heart rate, blood pressure, respiratory rate, and oxygen saturation were recorded every 5 min for each child. In addition, recovery and discharge times were recorded.


RESULTS
All 42 procedures were completed with no complications. The combination of propofol and remifentanil resulted in a decrease in heart rate, blood pressure, and respiratory rate. There was no respiratory depression or oxygen desaturation in any child. A bolus of propofol (1 mg x kg(-1)) was necessary in one child for excessive movement. No patient experienced any side effects in the recovery period.


CONCLUSIONS
The combination of propofol and remifentanil for sedation in children undergoing gastrointestinal endoscopy can be considered safe, effective and acceptable.
Abu-Shahwan
Ibrahim
I
Department of Anesthesiology, Children's Hospital of Eastern Ontario, 401 Smyth Rd, University of Ottawa, Ottawa, ON, Canada K1H 8L1. iabushahwan@cheo.on.ca
Mack
David
D
D000758:Anesthesia / Q000009:adverse effects / Q000379:methods*; D018685:Anesthetics, Inhalation / Q000008:administration & dosage; D018686:Anesthetics, Intravenous / Q000009:adverse effects / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D002648:Child; D002675:Child, Preschool; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007223:Infant; D008297:Male; D008738:Methyl Ethers / Q000008:administration & dosage; D016343:Monitoring, Intraoperative / Q000379:methods; D009609:Nitrous Oxide / Q000008:administration & dosage; D010100:Oxygen / Q000008:administration & dosage; D010880:Piperidines / Q000009:adverse effects / Q000627:therapeutic use*; D015742:Propofol / Q000009:adverse effects / Q000627:therapeutic use*; D011446:Prospective Studies; D000077208:Remifentanil; D012119:Respiration / Q000187:drug effects; D000077149:Sevoflurane; D013997:Time Factors; D016896:Treatment Outcome
D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D008738:Methyl Ethers; D010880:Piperidines; D000077149:Sevoflurane; D009609:Nitrous Oxide; D000077208:Remifentanil; D010100:Oxygen; D015742:Propofol