Determination of EC95 of Remifentanil for Smooth Emergence From Propofol Anesthesia in Patients Undergoing Transsphenoidal Surgery

Choi, Seung Ho; Min, Kyungha; Lee, Jeong Rim; Choi, Kwan Woong; Han, Kyunghwa; Kim, Eui Hyun; Oh, Hyo-Jung; Lee, Jae Hoon

doi:10.1097/ana.0000000000000094

Cited by 24 publications

(32 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[22,23] In several studies, a TCI of remifentanil during anesthetic emergence was reported to allow patients to recover from general anesthesia without coughing or hemodynamic instability, [8,23,24] and several studies extrapolated the effective Ce of remifentanil for preventing airway reflexes during anesthetic emergence. [7–10] …”

Section: Discussionmentioning

confidence: 99%

“…Knowledge of the remifentanil concentration in a particular patient undergoing a specific situation (procedure, use of anesthetic agents) is necessary because various factors influence the EC of remifentanil to suppress cough [9,10,25–27] : Sex affects the analgesic effects of opioids and the requirements of opioids for preventing cough during extubation is higher in male than in female. [25,26] The type of anesthetic agents used, such as propofol, sevoflurane, and desflurane, change the incidence of coughing during emergence.…”

Section: Discussionmentioning

confidence: 99%

“…[9,27] Airway irritation, including that due to an endotracheal tube, also could enhance the cough response. [10] …”

Section: Discussionmentioning

confidence: 99%

“…[20] The estimated EC 95 of remifentanil to prevent cough cannot be readily applied to clinical practice and should be confirmed in a properly designed study for determining EC 95 , like a biased coin design that can directly estimate EC at any quartile. [10] …”

Section: Discussionmentioning

confidence: 99%

“…[5–7] The effective effect-site concentration (Ce) of remifentanil for 50% and 95% of patients (EC 50 and EC 95 ) that prevents cough during emergence after general anesthesia using single-lumen tube (SLT) has been determined. [7–10] …”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Optimal effect-site concentration of remifentanil for preventing cough during removal of the double-lumen endotracheal tube from sevoflurane-remifentanil anesthesia

Lee

Yoo²,

Kim³

et al. 2016

Medicine

View full text Add to dashboard Cite

Opioids are used as a treatment for coughing. Recent studies have reported an antitussive effect of remifentanil during recovery from general anesthesia by suppressed coughing. The coughing reflex may differ throughout the respiratory tract from the larynx to the bronchi. But the proper dose of remifentanil to prevent cough during double-lumen tube (DLT) extubation is unknown.Twenty-five ASA physical status 1 and 2 patients, 20 to 65 years of age who were undergoing video-assisted thoracoscopic lung surgery requiring 1-lung ventilation were enrolled. The effective effect-site concentration (Ce) of remifentanil for 50% and 95% of patients (EC50 and EC95) for preventing cough was determined using the isotonic regression method with a bootstrapping approach, following the Dixon up-and-down method. Recovery profiles and hemodynamic values after anesthesia were compared between patients with cough and patients without cough.EC50 and EC95 of remifentanil was 1.670 ng/mL [95% confidence interval (95% CI) 1.393–1.806] and 2.275 ng/mL (95% CI 1.950–2.263), respectively. There were no differences in recovery profiles and hemodynamic values after anesthesia between patients with/without cough. No patients suffered respiratory complications during the emergence period.Remifentanil can be a safe and reliable method of cough prevention during emergence from sevoflurane anesthesia after thoracic surgery requiring DLT. EC50 and EC95 of remifentanil that suppresses coughing is 1.670 and 2.275 ng/mL, respectively.

show abstract