The safety and efficacy of remifentanil compared to fentanyl in pediatric endoscopy

Aim: To compare propofol combinations with low induction doses of remifentanil and fentanyl in respect to the complication frequency and efficiency in ease of procedure in children undergoing esophagogastroduodenoscopy. Materials and methods: Sixty-four patients, aged 3^-14 years and undergoing elective esophagogastroduodenoscopy, were included in the study. The patients received an induction dose of 0.25 μg kg^-1 remifentanil and 2 mg kg^-1 propofol (group R), or 0.5 μg kg^-1 fentanyl and 2 mg kg^-1 propofol (group F) before the procedure. The procedure began with a sedation score of ≥5. Hemodynamic values, movement, ease and duration of the procedure, the time to awakening, and any requirement for additional doses of propofol/opioids and adverse events were recorded. Results: Although frequency of apnea after induction was higher and the duration of apnea was longer in group R, during procedure and postprocedure follow-up, there were no apnea episodes in either group (P < 0.05, P > 0.05). Intraoperative respiratory rate, time to eye opening, opioid consumption, and duration of recovery were significantly shorter in group R (P < 0.05). Conclusion: Remifentanil, when combined with propofol, can provide as efficient and safe anesthesia as fentanyl propofol combination for procedures like esophagogastroduodenoscopy.