Optimal Effect-Site Concentration of Remifentanil for Inhibiting Response to Laryngeal Mask Airway Removal during Emergence
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Purpose: This randomized, controlled, double-blind study was designed to determinethe optimal dose of remifentanil for preventing complications associated with the removal of a laryngeal mask airway (LMA) without delaying emergence. Materialsand 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 emergenceand recovery profiles were recorded. Adverse events such as coughing, airwayobstruction, breath-holding, agitation, desaturation, nausea, and vomiting were also evaluated. Results: The number of patients with respiratory complicationssuch 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: Maintaininga 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.
Abstract
Purpose: This randomized, controlled, double-blind study was designed to determinethe optimal dose of remifentanil for preventing complications associated with the removal of a laryngeal mask airway (LMA) without delaying emergence. Materialsand 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 emergenceand recovery profiles were recorded. Adverse events such as coughing, airwayobstruction, breath-holding, agitation, desaturation, nausea, and vomiting were also evaluated. Results: The number of patients with respiratory complicationssuch 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: Maintaininga 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.
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