title: Dexmedetomidine vs remifentanil intravenous anaesthesia and spontaneous ventilation for airway foreign body removal in children.
abstract: BACKGROUND
  To compare the safety and efficacy of dexmedetomidine/propofol (DP)-total i.v. anaesthesia (TIVA) vs remifentanil/propofol (RP)-TIVA, both with spontaneous breathing, during airway foreign body (FB) removal in children.
  
  
  METHODS
  Seventy-seven children undergoing rigid bronchoscopy for FB removal were randomly allocated to receive either RP-TIVA and spontaneous ventilation (Group RP, n=38) or DP-TIVA and spontaneous ventilation (Group DP, n=39). Heart rate, arterial pressure, pulse oxygen saturation (Sp(O2)), respiratory rate, end-tidal CO2 (E'(CO2)), and induction time were recorded. Adverse events, the intervention for these events, and postoperative care duration were also assessed.
  
  
  RESULTS
  The mean induction times were comparable between the two groups (Group RP 12.2 min vs Group DP 13.1 min, P>0.05). At the end of the procedure, the mean (E'(CO2)) was higher in Group RP (Group RP 6.8 kPa vs Group DP 5.8 kPa, P<0.001), and respiratory rate was lower in Group RP (Group RP 20.4 vs Group DP 35.8, P<0.001). Additionally, the perioperative haemodynamic profile was more stable in Group DP than that in Group RP. The incidence rate of breath-holding and intervention were comparable between the two groups. In the post-anaesthesia care unit (PACU), no hypoxaemia was observed, and emergence time increased in Group DP (Group DP 65.1 min vs Group RP 23.8 min, P<0.0001). The incidence of cough in PACU was higher in Group RP (Group RP 55.3% vs Group DP 10.3%, P<0.0001).
  
  
  CONCLUSIONS
  Compared with RP-TIVA, DP-TIVA provided more stable respiratory and haemodynamic profiles, but required a longer recovery time. Clinical trial registration China Clinical Research Information Service, ChiCTR-TRC-13003018.
authors.affiliation: Department of Anesthesiology, The Eye, Ear, Nose and Throat Hospital of Fudan University, Shanghai Medical College of Fudan University, Shanghai 200031, China.
authors.forename: K-Z
authors.initials: KZ
authors.lastname: Chen
authors.forename: M
authors.initials: M
authors.lastname: Ye
authors.forename: C-B
authors.initials: CB
authors.lastname: Hu
authors.forename: X
authors.initials: X
authors.lastname: Shen
mesh_terms: D000402:Airway Obstruction / Q000601:surgery; D000762:Anesthesia Recovery Period; D000771:Anesthesia, Intravenous; D001794:Blood Pressure / Q000187:drug effects; D001999:Bronchoscopy / Q000379:methods; D002675:Child, Preschool; D020927:Dexmedetomidine; D005260:Female; D005547:Foreign Bodies / Q000601:surgery*; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006993:Hypnotics and Sedatives; D007223:Infant; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D010880:Piperidines; D000077208:Remifentanil; D012119:Respiration; D056152:Respiratory Rate / Q000187:drug effects; D013990:Tidal Volume / Q000187:drug effects; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D006993:Hypnotics and Sedatives; D010880:Piperidines; D020927:Dexmedetomidine; D000077208:Remifentanil
keywords: anaesthesia, paediatric; anaesthetic techniques, bronchoscopy; analgesics opioid, remifentanil; complications, hypoxaemia; pharmacology, dexmedetomidine