Skip Navigation



BJA Advance Access published online on May 2, 2009
British Journal of Anaesthesia, doi:10.1093/bja/aep090
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
102/6/775    most recent
aep090v1
Right arrow E-Letters: Submit a response to the article
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Lee, B.
Right arrow Articles by Na, S.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Lee, B.
Right arrow Articles by Na, S.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© The Author [2009]. Published by Oxford University Press on behalf of The Board of Directors of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournal.org

Targeting smooth emergence: the effect site concentration of remifentanil for preventing cough during emergence during propofol–remifentanil anaesthesia for thyroid surgery

B. Lee1, J.-R. Lee1,2,* and S. Na1,2

1 Department of Anaesthesiology and Pain Medicine
2 Anaesthesia and Pain Research Institute, Yonsei University College of Medicine, 250 Seongsan-no, Seodaemun-gu, 120-752 Seoul, Korea

* Corresponding author. E-mail: leejeongrim{at}gmail.com

Background: The administration of short-acting opioids can be a reliable and safe method to prevent coughing during emergence from anaesthesia but the proper dose or effect site concentration of remifentanil for this purpose has not been reported. We therefore investigated the effect site concentration (Ce) of remifentanil for preventing cough during emergence from anaesthesia with propofol–remifentanil target-controlled infusion.

Methods: Twenty-three ASA I–II grade female patients, aged 23–66 yr undergoing elective thyroidectomy were enrolled in this study. EC50 and EC95 of remifentanil for preventing cough were determined using Dixon's up-and-down method and probit analysis. Propofol effect site concentration at extubation, mean arterial pressure, and heart rate (HR) were compared in patients with smooth emergence and without smooth emergence.

Results: Three out of 11 patients with remifentanil Ce of 1.5 ng ml–1 and all seven patients with Ce of 2.0 ng ml–1 did not cough during emergence; the EC50 of remifentanil that suppressed coughing was 1.46 ng ml–1 by Dixon's up-and-down method, and EC95 was 2.14 ng ml–1 by probit analysis. Effect site concentration of propofol at awakening was similar in patients with a smooth emergence and those without smooth emergence, but HR and arterial pressure were higher in those who coughed during emergence. Clinically significant hypoventilation was not seen in any patient.

Conclusions: We found that the EC95 of effect site concentration of remifentanil to suppress coughing at emergence from anaesthesia was 2.14 ng ml–1. Maintaining an established Ce of remifentanil is a reliable method of abolishing cough and thereby targeting smooth emergence from anaesthesia.

Keywords: anaesthetic techniques, i.v. infusion; analgesics opioid, remifentanil; complications, extubation tracheal


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?




Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.