Sedation for bronchoscopy in children: Study
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In pediatric patients, flexible bronchoscopy requires deep sedation. Different sedation regimes are common, but only some of them include opioids. Due to their antitussive effect, the use of short acting opioids may be beneficial for this particular indication, but additional respiratory depression may lead to an increase of adverse events.

Researchers systematically compared sedation regimes in children undergoing flexible bronchoscopy with either propofol alone, or a combination of propofol and remifentanil. The primary outcome parameter was the frequency of coughing episodes during the intervention. Secondary outcome parameters were frequency and types of complications, patient satisfaction, examiner satisfaction, and recovery time after finishing the sedation.

50 children aged 1-17 years undergoing flexible bronchoscopy under deep sedation with propofol were randomly assigned to two groups: (PR) receiving propofol and remifentanil and (PP) receiving propofol only. Sedation depth was predefined as Comfort Score 10-13.

Significantly less coughing episodes were found ([med (IQR)] PR: 0.73/min; PP: 1.98 min) and shorter recovery time in group PR (PR: 13.5 min; PP: 21.0 min). Examiner's satisfaction was higher in group PR (PR: 10; PP: 9). The number of adverse events, patient satisfaction, and required propofol dose during the intervention did not differ between groups.

Conclusively, researchers suggested the combination of propofol with remifentanil instead of using propofol alone in pediatric procedural sedation for flexible bronchoscopy.