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Propofol versus Fentanyl for Sedation in Pediatric Bronchoscopy: A Randomized Controlled Trial

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Abstract

Objectives

To compare propofol and fentanyl to induce conscious sedation in children undergoing flexible bronchoscopy.

Study design

Randomized controlled trial.

Setting

Pediatric Pulmonology division at a tertiary care center in Delhi, India.

Participants

Children aged 3–15 years who underwent flexible bronchoscopy.

Intervention

Children received either intravenous propofol 1 mg/kg administered as a slow bolus over 1 minute followed by 2 mg/kg/hour infusion, or intravenous Fentanyl 2 µg/kg administered as a slow bolus over one minute.

Outcomes

Primary outcome was time to achieve conscious sedation (Ramsay score 3). Secondary outcomes were need for adjuvant midazolam, physician satisfaction, level of cough, recovery features, and side-effects in the groups.

Results

53 children (propofol 27, fentanyl 26) were enrolled in the study. The mean (SD) time taken to achieve Ramsay score 03 was lower in propofol than fentanyl [15.7 (4.4) s vs 206 (55) s, P<0.001]. Propofol arm had significantly higher physician satisfaction, less requirement of adjuvant midazolam, less coughing and faster regain of full consciousness. There was no difference in drug side-effects between the groups.

Conclusion

Propofol has a shorter sedation induction time, less coughing during procedure, less recovery time, and better physician satisfaction compared to fentanyl for flexible bronchoscopy in children.

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Acknowledgements

Pediatric Respiratory nurse, residents of Division of Pulmonology and staff of Pediatric day-care services, All India Institute of Medical Sciences, New Delhi.

Funding

Funding: None

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Authors and Affiliations

  1. Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, 110 029, India

    P. K. G. Gunathilaka, Kana Ram Jat, Jhuma Sankar, Rakesh Lodha & S. K. Kabra

Authors
  1. P. K. G. Gunathilaka
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  2. Kana Ram Jat
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  3. Jhuma Sankar
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  4. Rakesh Lodha
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  5. S. K. Kabra
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Contributions

Contributors: PKGG: involved in developing protocol, data collection, analysis and manuscript writing; KRJ: involved in developing protocol and manuscript writing; JS: involved in data analysis and manuscript writing; RL: involved in developing protocol, data analysis and manuscript writing; RL,KRJ, SKK: revised it critically for important intellectual content; SKK: involved in study idea, protocol development; data collection, manuscript writing and will act as guarantor for the study; all authors approved final version of manuscript.

Corresponding author

Correspondence to S. K. Kabra.

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Competing interest: None stated.

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Gunathilaka, P.K.G., Jat, K.R., Sankar, J. et al. Propofol versus Fentanyl for Sedation in Pediatric Bronchoscopy: A Randomized Controlled Trial. Indian Pediatr 56, 1011–1016 (2019). https://doi.org/10.1007/s13312-019-1681-5

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  • DOI: https://doi.org/10.1007/s13312-019-1681-5

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