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A comparison of fentanyl with tramadol during propofol-based deep sedation for pediatric upper endoscopy
Paediatric Anaesthesia, 09/30/2011
Clinical Article
Bedirli N et al. – Tramadol in pediatric patients undergoing upper gastrointestinal endoscopy (UGIE) provided sedation as efficient as fentanyl with a better hemodynamic and respiratory stability and provided a superior safety and tolerance in younger children.
Methods- Eighty patients with ASA I-II, aged 1-16 years, undergoing UGIE were included in this study.
- Baseline anesthesia was maintained with 1mg•kg-1 propofol, and then, the patients were randomly assigned to receive 2microgram•kg-1 fentanyl (group F, n=40) or 2mg•kg-1 tramadol (group T, n=40).
- Additional propofol, 0.5-1mg.kg-1, was administered when needed.
- Heart rate, mean arterial pressure, oxygen saturation (SpO2), and sedation scores were recorded at baseline, induction, and every 5min.
- Endoscopy duration, recovery time, and adverse effects were recorded.
- The data were separated for subgroup analyses based on the age of 0-2, 2-12, and over 12 years.
- Fentanyl significantly decreased the saturation at induction, 5thmin and 10thmin in patients of 0-2 years; at 5th and 10thmin in 2-12 years; and at 5thmin in>12 years.
- In all age subgroups, sedation scores at 10th, 15th, and 20th min, the overall frequency of adverse effects, and the recovery time were significantly lower in group T compared with group F.