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A Randomized Comparison of Remifentanil Target-Controlled Infusion Versus Dexmedetomidine Single-Dose Administration: A Better Method for Smooth Recovery From General Sevoflurane Anesthesia

 Park, Jeong-Soo  ;  Kim, Ki-Joon  ;  Lee, Jae Hoon  ;  Jeong, Woong-Yoon  ;  Lee, Jeong-Rim 
 AMERICAN JOURNAL OF THERAPEUTICS, Vol.23(3) : 690-696, 2016 
Journal Title
Issue Date
Adult ; Airway Extubation/adverse effects ; Analgesics, Non-Narcotic/administration & dosage ; Analgesics, Non-Narcotic/adverse effects ; Analgesics, Non-Narcotic/therapeutic use* ; Analgesics, Opioid/administration & dosage ; Analgesics, Opioid/adverse effects ; Analgesics, Opioid/therapeutic use* ; Anesthesia, General/adverse effects ; Anesthesia, General/methods ; Anesthetics, Inhalation/administration & dosage ; Anesthetics, Inhalation/adverse effects ; Anesthetics, Inhalation/therapeutic use* ; Arterial Pressure/drug effects ; Cough/prevention & control ; Dexmedetomidine/administration & dosage ; Dexmedetomidine/adverse effects ; Dexmedetomidine/therapeutic use* ; Drug Delivery Systems ; Female ; Heart Rate/drug effects ; Hemodynamics/drug effects ; Humans ; Infusions, Intravenous ; Methyl Ethers/administration & dosage ; Methyl Ethers/adverse effects ; Methyl Ethers/therapeutic use* ; Middle Aged ; Piperidines/administration & dosage ; Piperidines/adverse effects ; Piperidines/therapeutic use* ; Republic of Korea ; Respiratory Rate/drug effects
Remifentanil target-controlled infusion and dexmedetomidine single-dose administration are known to reduce airway response and hemodynamic stimulation during anesthetic recovery. We compared the effects of 2 drugs on the prevention of cough during emergence. We enrolled 70 female patients aged 20-60 years with American Society of Anesthesiologists (ASA) I-II who underwent general anesthesia for elective thyroidectomy. The patients were randomly assigned to remifentanil (group R) or dexmedetomidine (group D). Anesthesia was maintained with sevoflurane and effect-site target-controlled infusion of remifentanil. In group D, remifentanil was discontinued, and dexmedetomidine 0.5 μg/kg was given 10 minutes before the end of surgery. In group R, remifentanil target-controlled infusion at an effective-site concentration of 2.0 ng/mL was maintained during emergence until extubation. The cough grade, hemodynamic values, respiration, and other recovery profiles were evaluated during the periextubation period. The proportion of patients with no cough or just a single cough during extubation was significantly higher in group R than in group D (96.8% vs. 55.9%). The change of mean arterial pressure and heart rate were not significantly different during extubation in both groups. Respiratory rate and the incidence of residual sedation after extubation were lower in group R. There were no desaturation events and no differences in time to extubation or duration of postanesthesia care unit stay in both groups. Remifentanil target-controlled infusion reduces emergence cough from general anesthesia more effectively than single-dose dexmedetomidine. However, a single-dose of dexmedetomidine has the effect with respect to respiratory and hemodynamic stability during emergence.
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1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Ki Jun(김기준) ORCID logo https://orcid.org/0000-0003-1950-7998
Lee, Jae Hoon(이재훈) ORCID logo https://orcid.org/0000-0001-6679-2782
Lee, Jeong Rim(이정림) ORCID logo https://orcid.org/0000-0002-7425-0462
Chung, Woong Youn(정웅윤)
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