Propofol versus Fentanyl for Sedation in Pediatric Bronchoscopy: A Randomized Controlled Trial

Objectives: To compare propofol and fentanyl to induce conscious sedation in children undergoing flexible bronchoscopy. Study design: Randomized controlled trial. Setting: Pediatric Pulmonology division at a tertiary care center in Delhi, India. Participants: Children aged 3–15 years who underwent flexible bronchoscopy. Intervention: Children received either intravenous propofol 1 mg/kg administered as a slow bolus over 1 minute followed by 2 mg/kg/hour infusion, or intravenous Fentanyl 2 µg/kg administered as a slow bolus over one minute. Outcomes: Primary outcome was time to achieve conscious sedation (Ramsay score 3). Secondary outcomes were need for adjuvant midazolam, physician satisfaction, level of cough, recovery features, and side-effects in the groups. Results: 53 children (propofol 27, fentanyl 26) were enrolled in the study. The mean (SD) time taken to achieve Ramsay score 03 was lower in propofol than fentanyl [15.7 (4.4) s vs 206 (55) s, P<0.001]. Propofol arm had significantly higher physician satisfaction, less requirement of adjuvant midazolam, less coughing and faster regain of full consciousness. There was no difference in drug side-effects between the groups. Conclusion: Propofol has a shorter sedation induction time, less coughing during procedure, less recovery time, and better physician satisfaction compared to fentanyl for flexible bronchoscopy in children.