Effects of different doses of remifentanil infusion on hemodynamics and recovery in children undergoing pediatric diagnostic cardiac catheterization

J Cardiothorac Vasc Anesth. 2011 Aug;25(4):660-4. doi: 10.1053/j.jvca.2010.09.024. Epub 2010 Nov 24.

Abstract

Objective: The present study aimed to compare 2 different doses of remifentanil infusion on hemodynamics, recovery period, and complications in children undergoing diagnostic pediatric cardiac catheterization.

Design: A prospective study.

Setting: A university hospital.

Participants: Children undergoing diagnostic cardiac catheterization (n = 60).

Interventions: Children (2-12 years of age) scheduled for elective diagnostic cardiac catheterization under sedation were included in this study. The patients were assigned randomly to 2 groups as follows: patients in group 1 (n = 30) received a remifentanil infusion of 0.1 μg/kg/min, and patients in group 2 (n = 30) received a remifentanil infusion of 0.2 μg/kg/min. Heart rate (HR), systolic and diastolic blood pressures (BPs), oxygen saturation (SpO(2)), respiratory rate (RR), sedation, and recovery scores were recorded.

Measurements and main results: There were no significant differences between the groups in terms of systolic and diastolic BPs, HR, SpO(2), and RR during the study period. Additional drugs were required for 15 children in group 1; however, 27 patients maintained a satisfactory level of sedation with the 0.2-μg/kg/min remifentanil infusion. The time to achieve a recovery score of ≥5 was significantly shorter in group 2 than in group 1 (4.1 ± 0.3 minutes v 6.8 ± 0.8 minutes). No postoperative complications were reported in either group.

Conclusion: After oral midazolam premedication and local prilocaine infiltration, 0.2 μg/kg/min of remifentanil provided adequate sedation without any hemodynamic compromise during pediatric diagnostic cardiac catheterization.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Analgesics, Opioid / pharmacology*
  • Cardiac Catheterization*
  • Child
  • Child, Preschool
  • Dexmedetomidine / pharmacology
  • Female
  • Hemodynamics / drug effects*
  • Humans
  • Ketamine / pharmacology
  • Male
  • Midazolam / pharmacology
  • Piperidines / pharmacology*
  • Prospective Studies
  • Remifentanil

Substances

  • Analgesics, Opioid
  • Piperidines
  • Dexmedetomidine
  • Ketamine
  • Remifentanil
  • Midazolam