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- Title
Optimal effect-site concentration of remifentanil for preventing cough during emergence from sevoflurane-remifentanil anaesthesia.
- Authors
Jun, N. H.; Lee, J. W.; Song, J. W.; Koh, J. C.; Park, W. S.; Shim, Y. H.
- Abstract
This randomised, double-blinded, controlled trial was designed to identify the optimal dose of remifentanil for cough suppression without adverse effects during emergence from sevoflurane-remifentanil anaesthesia for thyroidectomy. One hundred and four patients were randomly assigned to maintain target effect-site concentrations of remifentanil at 0 (control group), 1.0 (remifentail 1 group), or 1.5 ng.ml−1 (remifentanil 1.5 group) during emergence. The incidence of coughing was lower in the remifentanil 1.5 group (31%) than in the control group (74%) or remifentanil 1 group (63%) (p = 0.0004). In addition, the severity of coughing during extubation was lower in the remifentanil 1.5 group (median (IQR [range]) 0 (0–1 [0–1]) than in the control group (1 (0–2 [0–3])) and remifentanil 1 group (1 (0–2 [0–3])) (p = 0.004). Haemodynamic changes were reduced, but emergence time and stay in the post-anaesthesia care unit was prolonged in the remifentanil 1.5 group. Maintaining the remifentanil effect-site concentration at 1.5 ng.ml−1 during emergence from sevoflurane-remifentanil anaesthesia reduces the incidence and severity of coughing without serious adverse events and may provide haemodynamic stability in patients undergoing thyroidectomy. However, awakening may be delayed.
- Subjects
PHARMACODYNAMICS; ANESTHETICS; THYROID gland surgery; COUGH; ANESTHESIA; INTRACRANIAL pressure; ANGIOTENSIN converting enzyme; PREVENTION
- Publication
Anaesthesia, 2010, Vol 65, Issue 9, p930
- ISSN
0003-2409
- Publication type
Article
- DOI
10.1111/j.1365-2044.2010.06450.x