Journal article
Determination of EC95 of Remifentanil for Smooth Emergence From Propofol Anesthesia in Patients Undergoing Transsphenoidal Surgery
Journal of neurosurgical anesthesiology, Vol.27(2), pp.160-166
04/01/2015
DOI: 10.1097/ANA.0000000000000094
PMID: 25105828
Abstract
Background: In patients undergoing pituitary surgery using a transsphenoidal approach, anesthesia emergence should be smooth with minimal coughing. Recent studies demonstrated that a target-controlled infusion of remifentanil effectively suppresses coughing induced by the endotracheal tube. We investigated the EC95 of remifentanil for smooth emergence without coughing from propofol anesthesia in patients undergoing transsphenoidal hypophysectomy. Materials and
Methods: A total of 41 patients undergoing transsphenoidal hypophysectomy, aged 20 to 65 years, with an ASA physical status of I or II, were enrolled. For all participants, anesthesia was induced and maintained with a target-controlled infusion of remifentanil and propofol using predicted effect-site concentration (Ce). A biased coin design up-and-down sequential allocation and isotonic regression method were used to determine the remifentanil EC95 to prevent emergence coughing. In addition, we observed recovery profiles after anesthesia.
Results: According to the study design, 19 patients received remifentanil 2.6 ng/mL Ce and 22 patients received a lower Ce, ranging from 1.0 to 2.2 ng/mL. The EC95 of remifentanil to prevent coughing was estimated as 2.51 ng/mL (95% confidence interval, 2.28-2.57 ng/mL). Despite the exclusion of 1 case because of delayed emergence, 17 of 18 patients receiving 2.6 ng/mL of remifentanil had bradypnea (<10 breaths/min) until 3 minutes after extubation. However, end-tidal carbon dioxide was maintained below 55 mm Hg during anesthetic emergence and respiratory rate recovered within 20 minutes of admission to the postanesthetic care unit.
Conclusions: The EC95 of remifentanil for smooth emergence from anesthesia was 2.51 ng/mL after transsphenoidal hypophysectomy.
Details
- Title: Subtitle
- Determination of EC95 of Remifentanil for Smooth Emergence From Propofol Anesthesia in Patients Undergoing Transsphenoidal Surgery
- Creators
- Seung Ho Choi - Yonsei UniversityKyeong Tae Min - Yonsei UniversityJeong-Rim Lee - Yonsei UniversityKwan Woong Choi - Yonsei UniversityKyung-Hwa Han - Gangnam Med Res Ctr, Biostat Collaborat Unit, Seoul, South KoreaEui Hyun Kim - Yonsei UniversityHye Jin Oh - Yonsei UniversityJae Hoon Lee - Yonsei University
- Resource Type
- Journal article
- Publication Details
- Journal of neurosurgical anesthesiology, Vol.27(2), pp.160-166
- DOI
- 10.1097/ANA.0000000000000094
- PMID
- 25105828
- NLM abbreviation
- J Neurosurg Anesthesiol
- ISSN
- 0898-4921
- eISSN
- 1537-1921
- Publisher
- Lippincott Williams & Wilkins
- Number of pages
- 7
- Language
- English
- Date published
- 04/01/2015
- Academic Unit
- Anesthesia
- Record Identifier
- 9984806611202771
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