The authors have no funding, financial relationships, or conflicts of interest to disclose.
Effect-site concentration of remifentanil to prevent cough after laryngomicrosurgery
Article first published online: 31 MAY 2013
Copyright © 2013 The American Laryngological, Rhinological and Otological Society, Inc.
Volume 123, Issue 12, pages 3105–3109, December 2013
How to Cite
Chang, C. H., Lee, J. W., Choi, J. R. and Shim, Y. H. (2013), Effect-site concentration of remifentanil to prevent cough after laryngomicrosurgery. The Laryngoscope, 123: 3105–3109. doi: 10.1002/lary.24199
- Issue published online: 25 NOV 2013
- Article first published online: 31 MAY 2013
- Accepted manuscript online: 20 MAY 2013 03:00AM EST
- Manuscript Revised: 22 APR 2013
- Manuscript Accepted: 22 APR 2013
The aim of this study was to discover the optimal effect-site concentration of remifentanil for cough prevention that does not delay awakening or cause respiratory depression during emergence from anesthesia with propofol and remifentanil in laryngomicrosurgery patients.
Prospective, randomized, controlled trial.
One hundred five patients were randomly assigned to maintain an effect-site concentration (Ce) of remifentanil at a predetermined value of 1 (R1), 1.5 (R1.5), and 2 (R2) ng/mL during emergence. The incidence and grade (0, no coughing; 1, single cough; 2, more than one episode of nonsustained coughing; 3, sustained and repetitive coughing with head lift) of cough, emergence time, blood pressure (MAP), heart rate (HR), spontaneous respiratory rate, oxygen saturation, and postoperative nausea and vomiting (PONV) were recorded during emergence and recovery.
The total number of patients with coughing during emergence was lower in groups R1.5 and R2 than in group R1. The cough grade during tracheal extubation was lower in groups R1.5 and R2 than in group R1. In group R2, emergence time was longer and postanesthesia care unit score was lower than in groups R1 and R1.5. Also in group R2, transient hypoventilation and PONV were more frequent compared to group R1. There were no differences in MAP and HR among the three groups during emergence and recovery.
Maintenance of remifentanil at Ce 1.5 and 2 ng/mL suppressed coughing without serious adverse events during emergence from anesthesia with propofol and remifentanil in patients undergoing laryngomicrosurgery.
Level of Evidence
1b Laryngoscope, 123:3105–3109, 2013