The Effect of Dexmedetomidine for Emergence Cough

Study Overview
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Brief Summary
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Dexmedetomidine or remifentanil are effective in attenuating cough during peri-extubation period after general anesthesia. The purpose of this study was to investigate the effect of dexmedetomidine on the remifentanil concentration for the cough suppression during anesthetic emergence.

Detailed Description
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Administration of dexmedetomidine before end of surgery could reduce airway reflexes and hemodynamic changes during tracheal extubation. Compared with remifentanil alone, administration of dexmedetomidine in combination with remifentanil is effective in relieving cough and hemodynamic changes without inhibition of respiration. The purpose of this study was to investigate the effect of dexmedetomidine on the remifentanil concentration for the cough suppression during anesthetic emergence using the modified up-and-down method.

Official Title
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The Effect of Dexmedetomidine on the Remifentanil Concentration for Preventing Cough During Emergence After Propofol Anesthesia

Conditions
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Cough

Intervention / Treatment
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* Drug: Dexmedetomidine
* Drug: Remifentanil
* Drug: Normal saline


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: ASA physical status I or II undergoing endoscopic sinus surgery or septoplasty under general anesthesia Exclusion Criteria: predicted difficult airway body mass index > 35 kg/m2, recent upper respiratory infection asthma current smoker patients using angiotensin converting enzyme-inhibitors uncontrolled hypertension

Ages Eligible for Study
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Minimum Age: 19 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Dexmedetomidine<br>Dexmedetomidine was infused before end of surgery and remifentanil was maintained at predetermined effect-site concentration during the emergence period | Drug: Dexmedetomidine<br>* Dexmedetomidine 0.5mcg/kg was infused over 10 min before end of the surgery<br>* Other names: Prededex;Drug: Remifentanil<br>* Remifentanil was maintained at predetermined effect-site concentration during the periextubation period (initial concentration: 2.0 ng/ml)<br>* Other names: Ultiva;|
| Active Comparator: Remifentanil<br>Normal saline was infused before end of surgery and remifentanil was maintained at predetermined effect-site concentration during the emergence period | Drug: Remifentanil<br>* Remifentanil was maintained at predetermined effect-site concentration during the periextubation period (initial concentration: 2.0 ng/ml)<br>* Other names: Ultiva;Drug: Normal saline<br>* Normal saline was infused over 10 min before end of the surgery<br>* Other names: 0.9% NaCl;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of cough | Number of cough or a strong and sudden contraction of the abdomen during periextubation periextubation periods | from end of surgery to 5 min after tracheal extubation] | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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dexmedetomidine, remifentanil, extubation