Propofol/remifentanil versus propofol alone for bone marrow aspiration in paediatric haemato-oncological patients

Background: This prospective randomized study was designed to evaluate the effects of adding remifentanil to the standard propofol-based technique in the setting of paediatric haematology-oncology outpatient clinic. Methods: Eighty ASA III paediatric patients treated in the outpatient haematology-oncology clinic requiring bone marrow aspiration were randomly assigned either to the propofol (P) or the propofol/remifentanil (PR) group. The quality of anaesthesia and recovery were evaluated. Results: The total amount of propofol required to prevent patient movement was lower in the PR group. The time interval to eye opening and to home readiness was significantly lower in the PR group. Adverse respiratory events (RR < 10.min(-1) or SpO(2) < 90%) occurred significantly more in the propofol/remifentanil group. Conclusions: The addition of remifentanil improved the conditions during the procedure and reduced the total amount of propofol, as well as the time to home readiness. However, the addition of remifentanil is associated with an increased risk of respiratory depression.