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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
- Source :
- Journal of Clinical Anesthesia. 26:466-474
- Publication Year :
- 2014
- Publisher :
- Elsevier BV, 2014.
-
Abstract
- 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 (EC 50 ) values of remifentanil for preventing coughing in the groups were estimated using isotonic regression and compared among the groups. Main Results The EC 50 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 EC 50 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.
- Subjects :
- Adult
Methyl Ethers
Anesthetics, General
medicine.medical_treatment
Remifentanil
Anesthetic Agent
Sevoflurane
Young Adult
Desflurane
Postoperative Complications
Piperidines
Intubation, Intratracheal
medicine
Humans
Prospective Studies
Thyroid Neoplasms
Propofol
Aged
Isoflurane
business.industry
Thyroidectomy
Middle Aged
Antitussive Agents
Anesthesiology and Pain Medicine
Cough
Bispectral index
Anesthesia
Anesthesia Recovery Period
Anesthetic
Female
business
medicine.drug
Subjects
Details
- ISSN :
- 09528180
- Volume :
- 26
- Database :
- OpenAIRE
- Journal :
- Journal of Clinical Anesthesia
- Accession number :
- edsair.doi.dedup.....147cd2e4b032068dbbfaebdfe178e310