A Comparison between Total Intravenous Anaesthesia Using Propofol plus Remifentanil and Propofol plus Sevoflurane in Children undergoing Fibreoptic Bronchoscopy：A Randomized, Single-Blind Study

Abstract BackgroundFibreoptic bronchoscopy is an important used to evaluate and manage paediatric patients with respiratory disease.This study aimed to compare the effect of two different anaesthesia methods, propofol combined with remifentanil and propofol combined with sevoflurane, on children undergoing fibreoptic bronchoscopy (FOB).Method:Sixty children were enrolled and randomly divided into two groups. In the remifentanil group (Group R), the patients were induced with 4 mg•kg− 1 propofol + 4 µg•kg− 1 remifentanil (slow intravenous injection) and maintained with 0.3–0.5 µg•kg− 1•min− 1 remifentanil. In the sevoflurane group (Group S), the patients were induced with 2 mg•kg− 1 propofol and 8% sevoflurane and maintained with 4–6 vol% sevoflurane. Heart rate (HR), mean blood pressure (MBP) and pulse oxygen saturation (SpO2) were monitored and recorded at four time points: baseline (T0), when the bronchoscope reached glottis (T1), the time of lavage (T2), and the time of brush biopsy (T3). Waking time and the satisfaction score of physicians were recorded, and emergence agitation (EA) was evaluated in the postanesthesia care unit (PACU). Finally, any supplementary medicine or adverse events were also recorded.ResultsCompared with group S, the waking time was significantly shorter and the incidence of EA was significantly lower in Group R. During bronchoscopy, significant differences in MAP or HR were not observed between the two groups at T0. Compared with group S, the HR of group R was significantly decreased at T1, T2 and T3, and MAP was significantly decreased at T1, but the fluctuation range was within 20% of the baseline. A significant difference in SpO2 was not observed between the two groups at any time point. No significant differences in the operation time of FOB, the incidence of complications, such as moving, hypoxemia, bronchospasm, and bucking, or the level of satisfaction were observed between the two groups.ConclusionsTotal intravenous anaesthesia using propofol plus remifentanil in children undergoing fibreoptic bronchoscopy potentially reduces the waking time and decreases the incidence of EA to improve the work efficiency and turnover rate of the outpatient operating room.Trial registrationRegistered at the China Clinical Trial Registry (http://www.chictr.org.cn) (ChiCTR1900026098).