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Journal of Clinical Anesthesia
Article . 2014 . Peer-reviewed
License: Elsevier TDM
Data sources: Crossref
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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

Authors: Jae Hoon, Lee; Seung Ho, Choi; Yong Seon, Choi; Bahn, Lee; Shi Joon, Yang; Jeong-Rim, Lee;

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

Abstract

To investigate whether the type of anesthetic agent administered affects the antitussive effect of remifentanil.Prospective randomized study.Operating room of a university hospital.78 ASA physical status 1 and 2 women, aged 20 to 65 years, who were scheduled to undergo a thyroidectomy.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.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.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.Remifentanil administration for cough suppression during emergence should be customized to the anesthetic agent.

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Keywords

Adult, Methyl Ethers, Cough/prevention & control*, Piperidines/therapeutic use, Piperidines/administration & dosage*, Anesthetics, General, Antitussive Agents/therapeutic use, 610, Thyroid Neoplasms/surgery, Methyl Ethers/adverse effects, Remifentanil, Antitussive Agents/administration & dosage*, Young Adult, Sevoflurane, General/adverse effects*, Postoperative Complications, Piperidines, Cough/etiology, 617, Intubation, Intratracheal, Humans, Prospective Studies, Thyroid Neoplasms, Propofol, Anesthetics, Aged, Isoflurane/analogs & derivatives, Isoflurane, Isoflurane/adverse effects, Intratracheal/adverse effects*, Propofol/adverse effects, Postoperative Complications/prevention & control*, Middle Aged, Antitussive Agents, Cough, Anesthesia Recovery Period, Thyroidectomy, Female, Intubation, Desflurane

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
12
Top 10%
Average
Average
Green