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Predicting effective remifentanil concentration in 95% of patients to prevent emergence cough after laryngomicroscopic surgery

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dc.contributor.authorKim, HY-
dc.contributor.authorKim, JY-
dc.contributor.authorAhn, SH-
dc.contributor.authorLee, SY-
dc.contributor.authorPark, HY-
dc.contributor.authorKwak, HJ-
dc.date.accessioned2019-11-13T00:18:45Z-
dc.date.available2019-11-13T00:18:45Z-
dc.date.issued2018-
dc.identifier.issn0025-7974-
dc.identifier.urihttp://repository.ajou.ac.kr/handle/201003/17021-
dc.description.abstractSmooth emergence or cough prevention is a clinically important concern in patients undergoing laryngomicroscopic surgery (LMS). The purpose of this study was to estimate the effective concentration of remifentanil in 95% of patients (EC95) for the prevention of emergence cough after LMS under propofol anesthesia using the biased coin design (BCD) up-down method.A total of 40 adult patients scheduled to undergo elective LMS were enrolled. Anesthesia induction and maintenance were performed with target-controlled infusion of propofol and remifentanil. Effective effect-site concentration (Ce) of remifentanil in 95% of patients for preventing emergence cough was estimated using a BCD method (starting from 1 ng/mL with a step size of 0.4 ng/mL). Hemodynamic and recovery profiles were observed after anesthesia.According to the study protocol, 20 patients were allocated to receive remifentanil Ce of 3.0 ng/mL, and 20 patients were assigned to receive lower concentrations of remifentanil, from 1.0 to 2.6 ng/mL. Based on isotonic regression with a bootstrapping method, EC95 (95% CI) of remifentanil Ce for the prevention of emergence cough from LMS was found to be 2.92 ng/mL (2.72-2.97 ng/mL). Compared with patients receiving lower concentrations of remifentanil, the incidence of hypoventilation before extubation and extubation time were significantly higher in those receiving remifentanil Ce of 3.0 ng/mL. However, hypoventilation incidence after extubation and staying time in the recovery room were comparable between the 2 groups.Using a BCD method, the EC95 of remifentanil Ce for the prevention of emergence cough was estimated to be 2.92 ng/mL (95% CI: 2.72-2.97 ng/mL) after LMS under propofol anesthesia.-
dc.language.isoen-
dc.subject.MESHAdult-
dc.subject.MESHAirway Extubation/adverse effects-
dc.subject.MESHAnesthesia/adverse effects-
dc.subject.MESHAnesthesia Recovery Period-
dc.subject.MESHAnesthetics, Intravenous/administration & dosage-
dc.subject.MESHAnesthetics, Intravenous/adverse effects-
dc.subject.MESHCough/etiology-
dc.subject.MESHCough/prevention & control-
dc.subject.MESHDose-Response Relationship, Drug-
dc.subject.MESHFemale-
dc.subject.MESHHumans-
dc.subject.MESHHypoventilation/epidemiology-
dc.subject.MESHHypoventilation/etiology-
dc.subject.MESHLaryngoscopy/adverse effects-
dc.subject.MESHMale-
dc.subject.MESHMicrosurgery/adverse effects-
dc.subject.MESHMiddle Aged-
dc.subject.MESHPiperidines/administration & dosage-
dc.subject.MESHPropofol/adverse effects-
dc.subject.MESHRemifentanil-
dc.titlePredicting effective remifentanil concentration in 95% of patients to prevent emergence cough after laryngomicroscopic surgery-
dc.typeArticle-
dc.identifier.pmid29952995-
dc.identifier.urlhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6039629/-
dc.subject.keywordcough-
dc.subject.keywordemergence-
dc.subject.keywordlaryngomicroscopic surgery-
dc.subject.keywordremifentanil-
dc.subject.keywordtarget-controlled infusion-
dc.contributor.affiliatedAuthor김, 하연-
dc.contributor.affiliatedAuthor김, 종엽-
dc.contributor.affiliatedAuthor이, 숙영-
dc.type.localJournal Papers-
dc.identifier.doi10.1097/MD.0000000000011258-
dc.citation.titleMedicine-
dc.citation.volume97-
dc.citation.number26-
dc.citation.date2018-
dc.citation.startPagee11258-
dc.citation.endPagee11258-
dc.identifier.bibliographicCitationMedicine, 97(26). : e11258-e11258, 2018-
dc.identifier.eissn1536-5964-
dc.relation.journalidJ000257974-
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Anesthesiology & Pain Medicine
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