Journal of Southern Medical University ›› 2024, Vol. 44 ›› Issue (9): 1631-1636.doi: 10.12122/j.issn.1673-4254.2024.09.01
Shafa Amir1, Montasery Mohammad2, Shahhosseini Sedighe1, Keivanfar Majid3, Mehr Asieh Maghami4, Babaei Mahtab Ebrahim5, Jafari Mohammad1()
Received:
2024-03-23
Accepted:
2024-07-09
Online:
2024-09-20
Published:
2024-09-30
Contact:
Jafari Mohammad
E-mail:mohammadjafari7263@gmail.com
Shafa Amir, Montasery Mohammad, Shahhosseini Sedighe, Keivanfar Majid, Mehr Asieh Maghami, Babaei Mahtab Ebrahim, Jafari Mohammad. Original ArticleRespiratory complications of propofol, sevoflurane, and dexmedetomidine anesthesia for fiberoptic bronchoscopy in children aged 1 month to 3 years: a randomized trial[J]. Journal of Southern Medical University, 2024, 44(9): 1631-1636.
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URL: https://www.j-smu.com/EN/10.12122/j.issn.1673-4254.2024.09.01
Characteristics | Dexmedetomidine group (n=40) | Sevofluranegroup (n=40) | Propofol group(n=40) | P |
---|---|---|---|---|
Sex [n (%)] | ||||
Boy | 27(67.5%) | 33(82.5%) | 22(55.0%) | 0.052 |
Girl | 13(32.5%) | 7(17.5%) | 18(45.0%) | |
Age (year, Mean±SD) | 1.40±1.33 | 1.43±1.73 | 1.38±1.40 | 0.989 |
Weight (kg, Mean±SD) | 9.97±5.21 | 8.37±5.08 | 8.16±3.38 | 0.100 |
Duration of bronchoscopy (min, Mean±SD) | 37.24±4.14 | 38.18±5.05 | 38.70±4.23 | 0.278 |
Tab.1 Demographic characteristics of the children in the 3 groups
Characteristics | Dexmedetomidine group (n=40) | Sevofluranegroup (n=40) | Propofol group(n=40) | P |
---|---|---|---|---|
Sex [n (%)] | ||||
Boy | 27(67.5%) | 33(82.5%) | 22(55.0%) | 0.052 |
Girl | 13(32.5%) | 7(17.5%) | 18(45.0%) | |
Age (year, Mean±SD) | 1.40±1.33 | 1.43±1.73 | 1.38±1.40 | 0.989 |
Weight (kg, Mean±SD) | 9.97±5.21 | 8.37±5.08 | 8.16±3.38 | 0.100 |
Duration of bronchoscopy (min, Mean±SD) | 37.24±4.14 | 38.18±5.05 | 38.70±4.23 | 0.278 |
Parameter | Time point | Dexmedetomidine group (n=40) | Sevoflurane group (n=40) | Propofol group (n=40) | P1 | P2 | P3 |
---|---|---|---|---|---|---|---|
MAP (mmHg) | Baseline | 98.37±7.28 | 96.95±17.19 | 96.76±10.36 | 0.098 | 0.096 | 0.545 |
T0 | 98.83±9.20 | 97.95±14.30 | 95.73±10.93 | 0.744 | 0.173 | 0.438 | |
T5 | 94.37±11.53 | 65.73±12.05 | 70.03±10.43 | <0.001 | <0.001 | 0.099 | |
T10 | 93.47±14.10 | 69.35±13.41 | 70.00±12.33 | <0.001 | <0.001 | 0.834 | |
T15 | 88.58±6.93 | 64.88±9.54 | 69.41±14.83 | 0.020 | <0.001 | 0.108 | |
R0 | 93.67±10.42 | 66.97±7.44 | 66.73±11.94 | <0.001 | <0.001 | 0.923 | |
R15 | 92.38±14.64 | 65.73±9.41 | 67.13±9.15 | <0.001 | <0.001 | 0.617 | |
R30 | 92.05±17.36 | 66.27±8.82 | 70.32±6.91 | <0.001 | <0.001 | 0.177 | |
P4 | <0.001 | 0.007 | 0.001 | ||||
HR (min-1) | Baseline | 127.08±18.09 | 138.85±23.69 | 128.63±43.69 | 0.088 | 0.222 | 0.104 |
T0 | 130.69±23.65 | 140.34±22.01 | 136.53±21.29 | 0.061 | 0.249 | 0.434 | |
T5 | 107.44±19.02 | 139.71±19.07 | 130.78±19.20 | <0.001 | <0.001 | 0.040 | |
T10 | 114.49±24.03 | 141.88±22.33 | 130.40±24.73 | <0.001 | 0.003 | 0.031 | |
T15 | 118.36±22.44 | 141.24±31.18 | 128.48±15.41 | 0.002 | 0.021 | 0.022 | |
R0 | 121.46±14.69 | 134.47±25.54 | 139.25±24.17 | 0.015 | <0.001 | 0.363 | |
R15 | 122.62±16.22 | 129.23±24.45 | 137.97±21.04 | 0.021 | 0.002 | 0.100 | |
R30 | 124.64±14.45 | 131.20±24.88 | 133.50±21.81 | 0.189 | 0.063 | 0.650 | |
P4 | <0.001 | 0.026 | <0.001 | ||||
SPO2 (%) | Baseline | 99.85±3.05 | 99.27±1.45 | 97.23±4.34 | 0.891 | 0.085 | 0.400 |
T0 | 97.87±3.25 | 98.90±1.59 | 98.10±3.91 | 0.104 | 0.078 | 0.241 | |
T5 | 96.54±2.98 | 96.44±3.29 | 97.15±5.37 | 0.912 | 0.501 | 0.428 | |
T10 | 97.21±2.35 | 97.61±2.84 | 96.25±6.01 | 0.658 | 0.300 | 0.136 | |
T15 | 95.85±3.41 | 94.90±7.11 | 96.72±4.93 | 0.508 | 0.520 | 0.232 | |
R0 | 98.36±1.81 | 98.23±5.00 | 95.95±5.59 | 0.906 | 0.018 | 0.035 | |
R15 | 97.95±2.60 | 99.23±1.19 | 97.71±2.75 | 0.027 | 0.659 | 0.010 | |
R30 | 97.41±2.18 | 99.03±1.16 | 97.67±3.09 | 0.005 | 0.636 | 0.020 | |
P4 | <0.001 | 0.001 | 0.019 |
Tab.2 Comparison of hemodynamic parameters among the 3 groups at different time points during bronchoscopy and recovery (Mean±SD)
Parameter | Time point | Dexmedetomidine group (n=40) | Sevoflurane group (n=40) | Propofol group (n=40) | P1 | P2 | P3 |
---|---|---|---|---|---|---|---|
MAP (mmHg) | Baseline | 98.37±7.28 | 96.95±17.19 | 96.76±10.36 | 0.098 | 0.096 | 0.545 |
T0 | 98.83±9.20 | 97.95±14.30 | 95.73±10.93 | 0.744 | 0.173 | 0.438 | |
T5 | 94.37±11.53 | 65.73±12.05 | 70.03±10.43 | <0.001 | <0.001 | 0.099 | |
T10 | 93.47±14.10 | 69.35±13.41 | 70.00±12.33 | <0.001 | <0.001 | 0.834 | |
T15 | 88.58±6.93 | 64.88±9.54 | 69.41±14.83 | 0.020 | <0.001 | 0.108 | |
R0 | 93.67±10.42 | 66.97±7.44 | 66.73±11.94 | <0.001 | <0.001 | 0.923 | |
R15 | 92.38±14.64 | 65.73±9.41 | 67.13±9.15 | <0.001 | <0.001 | 0.617 | |
R30 | 92.05±17.36 | 66.27±8.82 | 70.32±6.91 | <0.001 | <0.001 | 0.177 | |
P4 | <0.001 | 0.007 | 0.001 | ||||
HR (min-1) | Baseline | 127.08±18.09 | 138.85±23.69 | 128.63±43.69 | 0.088 | 0.222 | 0.104 |
T0 | 130.69±23.65 | 140.34±22.01 | 136.53±21.29 | 0.061 | 0.249 | 0.434 | |
T5 | 107.44±19.02 | 139.71±19.07 | 130.78±19.20 | <0.001 | <0.001 | 0.040 | |
T10 | 114.49±24.03 | 141.88±22.33 | 130.40±24.73 | <0.001 | 0.003 | 0.031 | |
T15 | 118.36±22.44 | 141.24±31.18 | 128.48±15.41 | 0.002 | 0.021 | 0.022 | |
R0 | 121.46±14.69 | 134.47±25.54 | 139.25±24.17 | 0.015 | <0.001 | 0.363 | |
R15 | 122.62±16.22 | 129.23±24.45 | 137.97±21.04 | 0.021 | 0.002 | 0.100 | |
R30 | 124.64±14.45 | 131.20±24.88 | 133.50±21.81 | 0.189 | 0.063 | 0.650 | |
P4 | <0.001 | 0.026 | <0.001 | ||||
SPO2 (%) | Baseline | 99.85±3.05 | 99.27±1.45 | 97.23±4.34 | 0.891 | 0.085 | 0.400 |
T0 | 97.87±3.25 | 98.90±1.59 | 98.10±3.91 | 0.104 | 0.078 | 0.241 | |
T5 | 96.54±2.98 | 96.44±3.29 | 97.15±5.37 | 0.912 | 0.501 | 0.428 | |
T10 | 97.21±2.35 | 97.61±2.84 | 96.25±6.01 | 0.658 | 0.300 | 0.136 | |
T15 | 95.85±3.41 | 94.90±7.11 | 96.72±4.93 | 0.508 | 0.520 | 0.232 | |
R0 | 98.36±1.81 | 98.23±5.00 | 95.95±5.59 | 0.906 | 0.018 | 0.035 | |
R15 | 97.95±2.60 | 99.23±1.19 | 97.71±2.75 | 0.027 | 0.659 | 0.010 | |
R30 | 97.41±2.18 | 99.03±1.16 | 97.67±3.09 | 0.005 | 0.636 | 0.020 | |
P4 | <0.001 | 0.001 | 0.019 |
Time point | Dexmedetomidine group (n=40) | Sevoflurane group (n=40) | Propofol group (n=40) | P1 | P2 | P3 | |
---|---|---|---|---|---|---|---|
T0 | 2.10±0.31 | 2.32±0.91 | 3.05±0.96 | 0.225 | <0.001 | <0.001 | |
T5 | 2.77±0.43 | 3.15±0.53 | 3.80±0.56 | 0.001 | <0.001 | <0.001 | |
T10 | 2.38±0.49 | 2.90±0.54 | 3.62±0.59 | <0.001 | <0.001 | <0.001 | |
T15 | 3.00±0.56 | 3.16±0.60 | 3.24±0.78 | 0.400 | 0.678 | 0.609 | |
R0 | 2.26±0.44 | 2.58±0.65 | 3.09±0.56 | 0.022 | <0.001 | 0.001 | |
R15 | 1.90±0.79 | 2.33±0.82 | 2.97±0.66 | 0.028 | <0.001 | 0.002 | |
R30 | 1.64±0.87 | 1.70±0.86 | 1.98±0.75 | 0.797 | 0.065 | 0.125 | |
P4 | <0.001 | 0.001 | <0.001 |
Tab.3 RSS scores of the children at different time points during bronchoscopy and recovery (Mean±SD)
Time point | Dexmedetomidine group (n=40) | Sevoflurane group (n=40) | Propofol group (n=40) | P1 | P2 | P3 | |
---|---|---|---|---|---|---|---|
T0 | 2.10±0.31 | 2.32±0.91 | 3.05±0.96 | 0.225 | <0.001 | <0.001 | |
T5 | 2.77±0.43 | 3.15±0.53 | 3.80±0.56 | 0.001 | <0.001 | <0.001 | |
T10 | 2.38±0.49 | 2.90±0.54 | 3.62±0.59 | <0.001 | <0.001 | <0.001 | |
T15 | 3.00±0.56 | 3.16±0.60 | 3.24±0.78 | 0.400 | 0.678 | 0.609 | |
R0 | 2.26±0.44 | 2.58±0.65 | 3.09±0.56 | 0.022 | <0.001 | 0.001 | |
R15 | 1.90±0.79 | 2.33±0.82 | 2.97±0.66 | 0.028 | <0.001 | 0.002 | |
R30 | 1.64±0.87 | 1.70±0.86 | 1.98±0.75 | 0.797 | 0.065 | 0.125 | |
P4 | <0.001 | 0.001 | <0.001 |
Complication | Dexmedetomidine group (n=40) | Sevoflurane group (n=40) | Propofol group (n=40) | P1 | P2 | P3 |
---|---|---|---|---|---|---|
Cough | ||||||
Baseline | 5 (12.5%) | 3 (7.5%) | 0 (0%) | 0.021* | 0.077** | 0.241*** |
T0 | 10 (25%) | 3 (7.5%) | 0 (0%) | 0.034* | 0.001** | 0.241*** |
T5 | 20 (50%) | 3 (7.5%) | 0 (0%) | <0.001* | <0.001** | 0.241*** |
T10 | 13 (32.5%) | 6 (15%) | 0 (0%) | 0.066* | <0.001** | 0.026*** |
T15 | 8 (20%) | 3 (7.5%) | 0 (0%) | 0.653 | <0.001 | <0.001 |
Bronchoscopist satisfaction | 3.74±0.85 | 3.83±1.12 | 4.75±0.44 | 0.653 | <0.001 | <0.001 |
Anesthetist satisfaction | 3.24±1.07 | 3.41±0.50 | 4.28±0.85 | 0.379 | <0.001 | <0.001 |
Laryngospasm | 6 (32.5%) | 10 (30%) | 3 (12.5%) | 0.264* | 0.288** | 0.034*** |
SPO2 declination | 5 (12.5%) | 0 (0%) | 7 (17.5%) | 0.021* | 0.531** | 0.012*** |
Recovery time | 33.46±6.40 | 41.25±11.99 | 51.71±10.28 | 0.001 | <0.001 | <0.001 |
Tab.4 Comparison of complications during and after bronchoscopy in the 3 groups
Complication | Dexmedetomidine group (n=40) | Sevoflurane group (n=40) | Propofol group (n=40) | P1 | P2 | P3 |
---|---|---|---|---|---|---|
Cough | ||||||
Baseline | 5 (12.5%) | 3 (7.5%) | 0 (0%) | 0.021* | 0.077** | 0.241*** |
T0 | 10 (25%) | 3 (7.5%) | 0 (0%) | 0.034* | 0.001** | 0.241*** |
T5 | 20 (50%) | 3 (7.5%) | 0 (0%) | <0.001* | <0.001** | 0.241*** |
T10 | 13 (32.5%) | 6 (15%) | 0 (0%) | 0.066* | <0.001** | 0.026*** |
T15 | 8 (20%) | 3 (7.5%) | 0 (0%) | 0.653 | <0.001 | <0.001 |
Bronchoscopist satisfaction | 3.74±0.85 | 3.83±1.12 | 4.75±0.44 | 0.653 | <0.001 | <0.001 |
Anesthetist satisfaction | 3.24±1.07 | 3.41±0.50 | 4.28±0.85 | 0.379 | <0.001 | <0.001 |
Laryngospasm | 6 (32.5%) | 10 (30%) | 3 (12.5%) | 0.264* | 0.288** | 0.034*** |
SPO2 declination | 5 (12.5%) | 0 (0%) | 7 (17.5%) | 0.021* | 0.531** | 0.012*** |
Recovery time | 33.46±6.40 | 41.25±11.99 | 51.71±10.28 | 0.001 | <0.001 | <0.001 |
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