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Differential effects of lidocaine and remifentanil on response to the tracheal tube during emergence from general anaesthesia.

Authors
 J. H. Lee  ;  B.-N. Koo  ;  J.-J. Jeong  ;  H.-S. Kim  ;  J.-R. Lee 
Citation
 BRITISH JOURNAL OF ANAESTHESIA, Vol.106(3) : 410-415, 2011 
Journal Title
 BRITISH JOURNAL OF ANAESTHESIA 
ISSN
 0007-0912 
Issue Date
2011
MeSH
Adult ; Aged ; Anesthesia Recovery Period ; Anesthesia, General/methods* ; Antitussive Agents/administration & dosage ; Antitussive Agents/therapeutic use* ; Cough/etiology ; Cough/prevention & control* ; Device Removal/adverse effects ; Female ; Humans ; Infusions, Intravenous ; Intubation, Intratracheal/adverse effects ; Lidocaine/administration & dosage ; Lidocaine/therapeutic use* ; Middle Aged ; Piperidines/administration & dosage ; Piperidines/therapeutic use* ; Postoperative Complications/prevention & control ; Thyroidectomy ; Treatment Outcome ; Young Adult
Keywords
anaesthesia ; generalanaesthetics local ; lidocaineanalgesics opioids ; remifentanilcomplications ; extubation trachealdrug deliveryinfusion
Abstract
BACKGROUND: I.V. lidocaine administration and target-controlled infusion (TCI) of remifentanil may each be used to reduce cough and haemodynamic stimulation during emergence from general anaesthesia. We therefore compared the effects of these two treatments on patients' responses to the tracheal tube during recovery from general anaesthesia after thyroid surgery. METHODS: Seventy female patients undergoing thyroidectomy under general anaesthesia using sevoflurane and remifentanil were randomly assigned to i.v. lidocaine (Group L, n=35) or remifentanil by TCI (Group R, n=35). At the end of surgery, sevoflurane was turned off, and the remifentanil infusion was stopped in Group L and maintained in Group R at an effect-site concentration of 2.0 ng ml(-1) until extubation. At the same time, i.v. lidocaine 1.5 mg ml(-1) was administered in Group L. The incidence and severity of cough, haemodynamic parameters, and recovery profiles were evaluated during the emergence. RESULTS: The incidence of cough during the emergence was significantly higher in Group L than in Group R (72.7% vs 20.6%, P<0.001) and so was the grade of cough (P<0.001). The mean arterial pressure and heart rate were significantly lower in the R group than in the L group during the emergence period (P<0.05), although the two groups showed comparable recovery profiles. CONCLUSIONS: TCI of remifentanil reduces responsiveness to the tracheal tube during emergence from general anaesthesia more effectively than does i.v. lidocaine in female patients undergoing thyroid surgery.
Files in This Item:
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DOI
10.1093/bja/aeq396
Appears in Collections:
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
Koo, Bon-Nyeo(구본녀) ORCID logo https://orcid.org/0000-0002-3189-1673
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
Jeong, Jong Ju(정종주) ORCID logo https://orcid.org/0000-0002-4155-6035
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/92773
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