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Optimal effect-site concentration of remifentanil for preventing cough during emergence from sevoflurane-remifentanil anaesthesia.

 N. H. Jun  ;  J. W. Lee  ;  J. W. Song  ;  J. C. Koh  ;  W. S. Park  ;  Y. H. Shim 
 ANAESTHESIA, Vol.65(9) : 930-935, 2010 
Journal Title
Issue Date
Adult ; Aged ; Analgesics, Opioid/administration & dosage* ; Analgesics, Opioid/adverse effects ; Anesthesia Recovery Period ; Anesthetics, Combined ; Anesthetics, Inhalation* ; Anesthetics, Intravenous ; Cough/prevention & control* ; Device Removal/adverse effects ; Double-Blind Method ; Drug Administration Schedule ; Female ; Hemodynamics/drug effects ; Humans ; Intubation, Intratracheal ; Male ; Methyl Ethers* ; Middle Aged ; Piperidines/administration & dosage* ; Piperidines/adverse effects ; Postoperative Complications/chemically induced ; Thyroidectomy
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.
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1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Park, Won Sun(박원선) ORCID logo https://orcid.org/0000-0003-3856-3987
Song, Jong Wook(송종욱) ORCID logo https://orcid.org/0000-0001-7518-2070
Shim, Yon Hee(심연희) ORCID logo https://orcid.org/0000-0003-1921-3391
Lee, Jong Wha(이종화)
Jun, Na Hyung(전나형)
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