Yonsei University, Medical Department reports research in anesthesia
2009 JUL 13 - (NewsRx.com) -- "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," scientists writing in the British Journal of Anaesthesia report. "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. 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. We found that the EC95 of effect site concentration of remifentanil to suppress coughing at emergence from anaesthesia was 2.14 ng ml(-1)," wrote B. Lee and colleagues, Yonsei University, Medical Department. The researchers concluded: "Maintaining an established Ce of remifentanil is a reliable method of abolishing cough and thereby targeting smooth emergence from anaesthesia.." Lee and colleagues published their study in British Journal of Anaesthesia (Targeting smooth emergence: the effect site concentration of remifentanil for preventing cough during emergence during propofol-remifentanil anaesthesia for thyroid surgery. British Journal of Anaesthesia, 2009;102(6):775-778). Additional information can be obtained by contacting J.R. Lee, Yonsei University, College Medical, Dept. of Anesthesiology & Pain Medical, 250 Seongsan No, Seoul 120752, South Korea. The publisher of the British Journal of Anaesthesia can be contacted at: Oxford University Press, Great Clarendon St., Oxford OX2 6DP, England. Keywords: South Korea, Seoul, Analgesia, Analgesic, Anesthesia, Anesthetic, Drugs, Hypnotics and Sedatives, Pain Medicine, Pharmaceuticals, Propofol, Remifentanil, Surgery, Therapy, Thyroidectomy, Treatment, Yonsei University, Medical Department. This article was prepared by Pain & Central Nervous System Week editors from staff and other reports. Copyright 2009, Pain & Central Nervous System Week via NewsRx.com.
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