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A Randomized Comparison of Remifentanil Target-Controlled Infusion Versus Dexmedetomidine Single-Dose Administration
- Source :
- American Journal of Therapeutics. 23:e690-e696
- Publication Year :
- 2016
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2016.
-
Abstract
- Remifentanil target-controlled infusion and dexmedetomidine single-dose administration are known to reduce airway response and hemodynamic stimulation during anesthetic recovery. We compared the effects of 2 drugs on the prevention of cough during emergence. We enrolled 70 female patients aged 20-60 years with American Society of Anesthesiologists (ASA) I-II who underwent general anesthesia for elective thyroidectomy. The patients were randomly assigned to remifentanil (group R) or dexmedetomidine (group D). Anesthesia was maintained with sevoflurane and effect-site target-controlled infusion of remifentanil. In group D, remifentanil was discontinued, and dexmedetomidine 0.5 μg/kg was given 10 minutes before the end of surgery. In group R, remifentanil target-controlled infusion at an effective-site concentration of 2.0 ng/mL was maintained during emergence until extubation. The cough grade, hemodynamic values, respiration, and other recovery profiles were evaluated during the periextubation period. The proportion of patients with no cough or just a single cough during extubation was significantly higher in group R than in group D (96.8% vs. 55.9%). The change of mean arterial pressure and heart rate were not significantly different during extubation in both groups. Respiratory rate and the incidence of residual sedation after extubation were lower in group R. There were no desaturation events and no differences in time to extubation or duration of postanesthesia care unit stay in both groups. Remifentanil target-controlled infusion reduces emergence cough from general anesthesia more effectively than single-dose dexmedetomidine. However, a single-dose of dexmedetomidine has the effect with respect to respiratory and hemodynamic stability during emergence.
- Subjects :
- Adult
Methyl Ethers
Mean arterial pressure
medicine.medical_specialty
Respiratory rate
Sedation
Remifentanil
Anesthesia, General
Sevoflurane
03 medical and health sciences
Drug Delivery Systems
0302 clinical medicine
Piperidines
Respiratory Rate
Heart Rate
030202 anesthesiology
Republic of Korea
Heart rate
medicine
Humans
Arterial Pressure
Pharmacology (medical)
Dexmedetomidine
Infusions, Intravenous
Pharmacology
business.industry
Hemodynamics
General Medicine
Analgesics, Non-Narcotic
Middle Aged
Surgery
Analgesics, Opioid
Cough
Anesthesia
Anesthetics, Inhalation
Anesthetic
Airway Extubation
Female
medicine.symptom
business
030217 neurology & neurosurgery
medicine.drug
Subjects
Details
- ISSN :
- 10752765
- Volume :
- 23
- Database :
- OpenAIRE
- Journal :
- American Journal of Therapeutics
- Accession number :
- edsair.doi.dedup.....1e2603c2027cace841ff92aab5f75cab