Higher doses of fentanyl during bronchoscopy in infants significantly reduces perioperative complication rates

Abstract Objectives The specific aim of this study was to assess the effect of higher fentanyl doses on reducing perioperative complication rates among infants undergoing rigid bronchoscopy. Methods Sixty children who underwent rigid bronchoscopy for foreign body removal were enlisted in our 2-year prospective cohort study at the Department of ENT and Head & Neck Surgery, Medical University – Sofia. Infants were randomly distributed into two groups according to fentanyl dose (group 1 - 1-2 μg/kg vs group 2 - 6-7 μg/kg). Hemodynamic parameters and perioperative complications were recorded. Results The mean age of the whole study group was 1.94 years. Five minutes prior to anesthesia both groups presented with similar parameter levels and no statistically significant difference was found. In contrast, at 5th and 10th minutes after intubation the heart rate, systolic and diastolic blood pressure levels were recorded at significantly higher levels in group 1 compared to group 2 (p= .000). Same results were obtained five minutes after extubation. Additionally, after performing the Pearson chi-Square test we found that bronchospasm and laryngospasm were significantly more frequent among patients from group 1 infused with lower dosage of fentanyl in comparison to the infants that were administered with a higher dose of this medication (p=.020). Phi and Cramer's V tests both display moderate strength of this association (V=.302). Conclusion In the current study we propose refinement of current anesthetic protocols by using higher doses of fentanyl during rigid bronchoscopy in infants. This significantly reduces perioperative complication rates and improves intraoperative hemodynamics without presenting any newly formed risks.