Comparison of the Optimal Effect-Site Concentrations of Remifentanil for Preventing Cough during Emergence from Desflurane or Sevoflurane Anaesthesia

• Published in: Journal of international medical research 2012-02, Vol.40 (1), p.174-183
• Main Authors: Cho, HB, Kim, JY, Kim, DH, Kim, DW, Chae, YJ
• Format: Article
• Language: English
• Subjects: Adult; Airway Extubation; Analgesics, Opioid - pharmacology; Analgesics, Opioid - therapeutic use; Anesthesia - adverse effects; Anesthesia Recovery Period; Anesthetics, Inhalation - adverse effects; Cough - drug therapy; Cough - etiology; Cough - physiopathology; Cough - prevention & control; Demography; Dose-Response Relationship, Drug; Female; Hemodynamics - drug effects; Humans; Isoflurane - adverse effects; Isoflurane - analogs & derivatives; Male; Methyl Ethers - adverse effects; Middle Aged; Piperidines - pharmacology; Piperidines - therapeutic use; Recovery of Function - drug effects; Thyroidectomy
• ISSN: 0300-0605; 1473-2300
• DOI: 10.1177/147323001204000118

OBJECTIVE: To compare the effect-site concentrations of remifentanil target-controlled infusion (TCI) that produced 50% and 95% of the maximal effect (EC50 and EC95, respectively) for preventing cough during emergence from desflurane or sevoflurane anaesthesia, in patients undergoing elective thyroidectomy. METHODS: Adults undergoing elective thyroidectomy were randomized to receive anaesthesia with desflurane or sevoflurane. The EC50 and EC95 values for remifentanil TCI were determined using Dixon's up-and-down method and probit analysis with sigmoid curve. RESULTS: In total, 48 patients aged 20 – 64 years were enrolled in the study. The EC50 ± SD of remifentanil TCI, determined by Dixon's up-and-down method, were 1.54 ± 0.70 and 1.11 ± 0.24 ng/ml for desflurane and sevoflurane, respectively. The EC95 of remifentanil TCI, analysed by probit analysis, were 2.88 ng/ml and 2.29 ng/ml for desflurane and sevoflurane, respectively. The effect-site concentration of remifentanil TCI for preventing cough during emergence from desflurane anaesthesia was not significantly higher than that observed for sevoflurane. CONCLUSIONS: During emergence from anaesthesia, variations in effect-site concentrations of remifentanil for preventing cough are of limited importance as they do not generate significant differences in results.