Optimal Effect-Site Concentration of Remifentanil for Inhibiting Response to Laryngeal Mask Airway Removal during Emergence.
10.3349/ymj.2015.56.2.529
- Author:
Sang Jin PARK
1
;
Jong Yun BAEK
;
Dae Lim JEE
Author Information
1. Department of Anesthesiology and Pain Medicine, College of Medicine, Yeungnam University, Daegu, Korea. apsj0718@naver.com
- Publication Type:Original Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
- Keywords:
Emergence;
laryngeal mask airway;
remifentanil
- MeSH:
Adult;
Airway Management/*methods;
Anesthesia Recovery Period;
Anesthetics, Intravenous/*administration & dosage;
Cough/prevention & control;
Device Removal;
Dose-Response Relationship, Drug;
Double-Blind Method;
Female;
Humans;
Infusions, Intravenous;
Laryngeal Masks/*adverse effects;
Male;
Middle Aged;
Piperidines/*administration & dosage;
Postoperative Complications/prevention & control;
Psychomotor Agitation;
Vomiting/prevention & control
- From:Yonsei Medical Journal
2015;56(2):529-534
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: This randomized, controlled, double-blind study was designed to determine the optimal dose of remifentanil for preventing complications associated with the removal of a laryngeal mask airway (LMA) without delaying emergence. MATERIALS AND METHODS: This study randomly assigned 128 patients to remifentanil effect-site concentrations (Ce) of 0 ng/mL (group R0), 0.5 ng/mL (group R0.5), 1.0 ng/mL (group R1.0), and 1.5 ng/mL (group R1.5) during emergence. The emergence and recovery profiles were recorded. Adverse events such as coughing, airway obstruction, breath-holding, agitation, desaturation, nausea, and vomiting were also evaluated. RESULTS: The number of patients with respiratory complications such as coughing and breath-holding was significantly lower in the R1.0 and R1.5 groups than in the R0 group (p<0.05). Emergence agitation also decreased in the R1.0 and R1.5 groups (p<0.0083). The time to LMA removal was significantly longer in the R1.5 group than in the other groups (p<0.05). CONCLUSION: Maintaining a remifentanil Ce of 1.0 ng/mL during emergence may suppress adverse events such as coughing, breath-holding, and agitation following the removal of LMA without delayed awakening.
