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

ABSTRACT

Objectives: To compare propofol and fentanyl to induceconscious sedation in children undergoing flexiblebronchoscopy.Study design: Randomized controlled trial.Setting: Pediatric Pulmonology division at a tertiary care centerin Delhi, India.Participants: Children aged 3-15 years who underwentflexible bronchoscopy.Intervention Children received either intravenous propofol 1mg/kg administered as a slow bolus over 1 minute followed by 2mg/kg/hour infusion, or intravenous Fentanyl 2 μg/kgadministered as a slow bolus over one minute.Outcomes: Primary outcome was time to achieve conscioussedation (Ramsay score 3). Secondary outcomes were need foradjuvant midazolam, physician satisfaction, level of cough,recovery features, and side-effects in the groups.Results: 53 children (propofol 27, fentanyl 26) were enrolled inthe study. The mean (SD) time taken to achieve Ramsay score 03was lower in propofol than fentanyl [15.7 (4.4) s vs 206 (55) s,P<0.001]. Propofol arm had significantly higher physiciansatisfaction, less requirement of adjuvant midazolam, lesscoughing and faster regain of full consciousness. There was nodifference in drug side-effects between the groups.Conclusion: Propofol has a shorter sedation induction time, lesscoughing during procedure, less recovery time, and betterphysician satisfaction compared to fentanyl for flexiblebronchoscopy in children.