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Does the type of anesthetic agent affect remifentanil effect-site concentration for preventing endotracheal tube-induced cough during anesthetic emergence? Comparison of propofol, sevoflurane, and desflurane

 Jae Hoon Lee  ;  Seung Ho Choi  ;  Yong Seon Choi  ;  Bahn Lee  ;  Shi Joon Yang  ;  Jeong-Rim Lee 
 JOURNAL OF CLINICAL ANESTHESIA, Vol.26(6) : 466-474, 2014 
Journal Title
Issue Date
Adult ; Aged ; Anesthesia Recovery Period ; Anesthetics, General/adverse effects* ; Antitussive Agents/administration & dosage* ; Antitussive Agents/therapeutic use ; Cough/etiology ; Cough/prevention & control* ; Female ; Humans ; Intubation, Intratracheal/adverse effects* ; Isoflurane/adverse effects ; Isoflurane/analogs & derivatives ; Methyl Ethers/adverse effects ; Middle Aged ; Piperidines/administration & dosage* ; Piperidines/therapeutic use ; Postoperative Complications/prevention & control* ; Propofol/adverse effects ; Prospective Studies ; Thyroid Neoplasms/surgery ; Thyroidectomy ; Young Adult
Cough ; Desflurane ; Propofol ; Remifentanil ; Sevoflurane
STUDY OBJECTIVE: To investigate whether the type of anesthetic agent administered affects the antitussive effect of remifentanil. DESIGN: Prospective randomized study. SETTING: Operating room of a university hospital. PATIENTS: 78 ASA physical status 1 and 2 women, aged 20 to 65 years, who were scheduled to undergo a thyroidectomy. INTERVENTIONS: Patients were randomly assigned to three groups to receive anesthesia with propofol (Group P), sevoflurane (Group S), or desflurane (Group D). The main anesthetics were titrated to maintain a target Bispectral Index for hypnosis of 40 to 60. Remifentanil was administered via effect-site target-controlled infusion (TCI). To determine the effective remifentanil effect-site concentration (Ce) to suppress coughing in each group, the up-and-down sequential allocation design was used. MEASUREMENTS: The half maximal effective concentration (EC50) values of remifentanil for preventing coughing in the groups were estimated using isotonic regression and compared among the groups. MAIN RESULTS: The EC50 of remifentanil for cough suppression in Group P [1.60 ng/mL (98.3% CI, 0.92-1.75 ng/mL)] was statistically lower than in Group D [1.96 ng/mL (98.3% CI, 1.81-2.50 ng/mL)]. The EC50 in Group S was 1.75 ng/mL (98.3% CI, 1.39-2.13 ng/mL), which was higher than in Group P and lower than in Group D, but did not differ significantly from either group. CONCLUSIONS: Remifentanil administration for cough suppression during emergence should be customized to the anesthetic agent.
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1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Lee, Bahn(이반)
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
Choi, Seung Ho(최승호) ORCID logo https://orcid.org/0000-0001-8442-4406
Choi, Yong Seon(최용선) ORCID logo https://orcid.org/0000-0002-5348-864X
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