LAUSR

OBJECTIVES To compare between 2 sedoanalgesia regimes, the time from withdrawal of the medication until the patient wakes up and until extubation. METHODOLOGY Observational study on pediatric patients after elective surgery that needed mechanical ventilation for a period maximum to 72 h. We compared two independent groups of patients: group A: patients collected prospectively who received sedoanalgesia with propofof-remifentanil and group B: patients who received midazolam-fentanyl collected retrospectively by reviewing medical records and database of the unit. The main variables studied were: Age, weight, sex, interventions type, sedoanalgesia scales, drugs dosages, time from withdrawal of medication to awakening and extubation, and adverse effects. RESULTS We collected 82 patients, 43 in group A and 39 in group B. Age (arithmetical mean ± standard deviation of patients were 49 ± 65 months, weight 17 ± 16 kg. Mechanical ventilation medium time was 22 h (3-72), wake-up time from withdrawal after removing sedoanalgesia was of 11,8 ± 10,6 min group A and 137,3 ± 45 min group B (P < 0.001), extubation time after removing sedoanalgesia was of 24 ± 21 min group A and 230 ± 102 min group B (P < 0.001). Adverse effects were found in 10.5% of patients group A (7.9% agitation, 2.6% bradycardia), and 13% of patients group B (respiratrory depression after extubation) P = 0,572. CONCLUSIONS Patients treated with propofol-remifentanil have significantly shorter times to wake up, extubation and withdrawal from mechanical ventilation after stopping the medication. In the midazolam-fentanyl group, respiratory depression was more frequent, although the percentage of adverse effects were similar in both groups. Both the combination of propofol-remifentanil and midazolam-fentanyl appear to be effective as a sedative-analgesic regimen for patients undergoing mechanical ventilation after surgery.