Sedation for Short Hematologic-Oncologic Procedures in Children: Comparison of Propofol-Remifentanil, Propofol-Fentanyl

Introduction: Short hemato-oncologic procedures are usually painful in children and demand lack of movement. This condition requires sedation during the procedure outside the operating room.Aim: Comparison of the effetct of remifentanil and fentanyl on patients? vital signs, need of additional propofol usage, operator?s satisfaction, amount of movements, eye opening time and recovery time during short hemato-oncologic proceduresMaterials and Methods: Approval of the Local Ethical Committee and Ministry of Health?s Ethical Committee of drug and clinic researches were obtained and a single blind, prospective, randomized study performed on ASA I-III, 29 children between 2-18 years that undergo 60 short oncologic procedures. Groups defined as propofol-remifentanil (PR) and propofol-fentanyl (PF). Group PR received 2 mg.kg-1 propofol, then 0,5 µg.kg-1 remifentanil IV. Group PF received 2 mg.kg-1 propofol, then 0,5 µg.kg-1 fentanyl IV. Additional doses of IV propofol administered according to the movements (0.3-0.5 mg.kg-1). Systolic arterial pressure (SAP), diastolic arterial pressure (DAP), mean arterial pressure (MAP), peripheral oxygen saturation (SpO2), heart rate (HR) were recorded per 3 minutes during the procedure and per 5 minutes postoperatively. Postanesthesic Awakening Scores according to Postanesthetic Modified Alderete Scores (PMAS), eye opening time with call and recovery time also recorded.Results: There were no statistically significant differences in demographic values as hemodynamic parameters and additional doses of IV propofol between groups (p>0.05). In both groups operator?s satisfaction and additional doses of IV propofol were similar. Eye opening time with call (p=0.043) and recovery time (p=0.002) were lower in group PR, which are statistically significant.Conclusion: It is convenient to use propofol remifentanil combination for short hematologic-oncologic procedures in children because of early recovery.Keywords: Children, short oncologic procedures, sedation, propofol, remifentanil, fentanyl, bolus.