Effect of Remifentanil on Cough During Emergence From General Anesthesia : Trial to Compare Between Sevoflurane Anesthesia and Propofol Anesthesia
Condition: Elective Thyroidectomy
Study type: Interventional
Phase: Phase 4

Summary: 
      The objective of this study was to compare the effect of remifentanil on suppression cough
      reflex during emergence in patient anesthetized using either propofol or sevoflurane
      additionally under infusion of the identical concentration of remifentanil.
    

Detailed description: 
      During recovery from general anesthesia the stimuli of endotracheal tube lead to the
      coughing, hypertension, tachycardia, which can cause a serious complication.

      It has been demonstrated that opioid, intravenous or topical lidocaine administration can
      attenuate the coughing reflex.

      Administered the opioid before emergence, it is effective to prevent cough reflex but the
      recovery is delayed, it was difficult to predict emergence.

      However, remifentanil is an opioid widely used because of rapid context-sensitive half-life,
      target-controled infusion method to adequately maintain the effect site concentration could
      help to predict the recovery time to the alert state from the general anesthesia. It is
      considered proper method of continuous infusion of remifentanil for reducing emergence cough.

      Recent reporters suggest that antitussive effect of remifentanil differs depend on main
      anesthetic agents, the incidence of coughing when tracheal extubation is reduced after
      propofol anesthesia compared with sevoflurane anesthesia.

      However, these studies raise important questions about failure of maintaining the same effect
      site concentration of remifentanil in both groups.

      The objective of this study was to compare the effect of remifentanil on suppression cough
      reflex during emergence in patient anesthetized using either propofol or sevoflurane
      additionally under infusion of the identical concentration of remifentanil.

      During recovery from general anesthesia the stimuli of endotracheal tube lead to the
      coughing, hypertension, tachycardia, which can cause a serious complication.

      It has been demonstrated that opioid, intravenous or topical lidocaine administration can
      attenuate the coughing reflex.

      Administered the opioid before emergence, it is effective to prevent cough reflex but the
      recovery is delayed, it was difficult to predict emergence.

      However, remifentanil is an opioid widely used because of rapid context-sensitive half-life,
      target-controled infusion method to adequately maintain the effect site concentration could
      help to predict the recovery time to the alert state from the general anesthesia. It is
      considered proper method of continuous infusion of remifentanil for reducing emergence cough.

      Recent reporters suggest that antitussive effect of remifentanil differs depend on main
      anesthetic agents, the incidence of coughing when tracheal extubation is reduced after
      propofol anesthesia compared with sevoflurane anesthesia.

      However, these studies raise important questions about failure of maintaining the same effect
      site concentration of remifentanil in both groups.

      The objective of this study was to compare the effect of remifentanil on suppression cough
      reflex during emergence in patient anesthetized using either propofol or sevoflurane
      additionally under infusion of the identical concentration of remifentanil.
    

Intervention name(s): Remifentanil
Intervention type(s): Drug
Intervention description(s): propofol group : propofol effect site-TCI 2-4mcg/ml + remifentanil effect site-TCI 2-4ng/ml
sevoflurane group: sevoflurane end-tidal concentration 0.5-1.0 MAC + remifentanil effect site-TCI 2-4ng/ml
Other intervention name(s): Ultiva
Intervention MeSH terms: Remifentanil
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Investigator)
Primary purpose: Prevention