Effect-site Concentration of Remifentanil for Smooth Removal of the Double-lumen Endotracheal Tube
Status:
Completed
Trial end date:
2015-08-01
Target enrollment:
Participant gender:
Summary
Smooth emergence is important for patient safety and satisfaction. Coughing during emergence
is associated with detrimental effects like laryngospasm, sore throat, hoarseness, negative
pressure pulmonary edema and bleeding at surgical site 1. Especially sore throat and
hoarseness are most common complications after extubation 2,3 and closely related to patient
satisfaction 4. Using double lumen tube (DLT) increase the incidence of hoarseness and airway
injury than using single lumen tube for it has large size5,6. Various technique and drugs
have been proposed for reducing coughing during extubation including smooth emergence 1,7-11
and this is closely correlate with reducing sore throat and hoarseness 12. One of the
proposed technique, the use of short acting opioids are prefered13-15 because it can be
maintained during emergence with less respiratory depression. Remifentanil is a potent short
acting opioid and several studies choose remifentanil combined with other anesthetic agents
1,15,16. There is a study about the EC50 and EC95 of remifentanil in effect site Target
controlled infusion(TCI) for preventing cough during emergence after thyroidectomy with
propofol-remifentanil anesthesia 15 but no study about the proper dose of remifentanil for
smooth DLT extubation.
The purpose of this study was to evaluate the EC50 and EC95 of remifentanil in effect-site
TCI for preventing cough during extubation of DLT in total TIVA with propofol and
remifentanil.