Diferentes dosis de fentanilo para realizar endoscopias digestivas altas en respiración espontánea: efectos en las necesidades de propofol y en el valor del índice biespectral

Introduction: Intravenous analgosedation with a combination of both hypnotics and opioids is often used for upper gastrointestinal endoscopy. Patients and method: Case reports retrospective study of children aged 1 to 14 yr who required diagnostic UGE. Intravenous analgosedation protocol was accomplished with fentanyl plus propofol. Three different fentanyl doses are compared: 1, 1.5 and 2 μg/kg. The objective was to assess the effect that different fentanyl dosages produce in propofol requirements and BIS level for effective sedation in UGE. The main variables were propofol total dose adjusted to body weight and effective BIS level at execution of UGE. Results: 155 patients met the inclusion criteria. F1 group, 61 patients; F1.5, 28, and F2, 66. They were not homogeneous regarding age nor weight; sex distribution was homogeneous instead. Propofol total dose was significant lower in both F1.5 and F2 compared to the F1 group. BIS was significant higher in F2 group relating to F1 group, but there wasn’t significant difference between F2 and F1.5 groups. Conclusions: When an analgosedation protocol for UGE in spontaneous breathing pediatric patients is accomplished with a combination of fentanyl and propofol, lesser amount of propofol is needed with 1.5 μg/kg fentanyl dose (in comparison with 1 μg/kg) and less sedation level (measured by BIS) is necessary. Higher fentanyl dose (2 μg/kg) does not seem to have advantages respect to 1.5 μg/kg.