Comparison of Deep Extubation During Emergence Using Desflurane or Desflurane With Remifentanil in Patients Undergoing General Anesthesia

Study Overview
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Brief Summary
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It has been reported that deep extubation can reduce cardiopulmonary complication against endotracheal tube extubation during emergence from general anesthesia. The investigators hypothesized that using desflurane with target controlled infusion of remifentanil is more effective than using desflurane alone during deep extubation. The purpose of this study is to evaluate the effect of remifentanil to prevent respiratory complication (etc. coughing) during emergence from general anesthesia.

Conditions
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Deep Extubation

Intervention / Treatment
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* Drug: Desflurane with remifentanil
* Drug: Desflurane


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age 20-60 patients undergoing elective surgery take more than an hour Under general anesthesia using an LMA ASA I,II Exclusion Criteria: Patients on CNS depressants Chronic opioid use Corticosteroid Pregnant patients Full stomach Morbidly obese (BMI >35kg/m2) Hepatitis B Hepatitis C Coronary artery disease Liver disease Renal disease Seizure disorder Dropout criteria: Need for reintubation due to breath holding high ETCO2 during self ventilation (ETCO2>50) Surgeon or patient request

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 60 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: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Desflurane group<br>1.5 MAC desflurane until extubation | Drug: Desflurane<br>* During the emergence from anesthesia,extubation was performed under 1.5 MAC desflurane<br>* Other names: Desflurane alone group;|
| Active Comparator: Desflurane with remifentanil group<br>1.0 MAC desflurane with 1.0ng/ml targeted concentration infusion of remifentanil | Drug: Desflurane with remifentanil<br>* During the emergence from anesthesia,extubation was performed under 1.0 MAC desflurane with 1.0ng/ml remifentanil<br>* Other names: desflurane with remifetanil group;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Awakening Time | The outcomes assessor will record from the time of extubation in operating room to the time of eye opening and mouth opening | Participants will be followed from the time of extubation in operating room to the time of discharge from recovery room, an expected average of 1day. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Success Rate & Complication Rate Including Cough | We will assess the success rate of deep extubation without complication and the occurrence of cough during emergence from general anesthesia. | assessing the success rate of deep extubation without complication and the occurrance of cough from the completion of surgery to 5minute after extubation. |