Effect-site concentration of remifentanil for preventing cough during emergence in elderly patients undergoing nasal surgery: a comparison with adult patients

Ji Young Yoo,1 Jong Yeop Kim,1 Hyun Jeong Kwak,2 Dong Chul Lee,2 Go Wun Kim,1 Sook Young Lee,1 Yun Jeong Chae1 1Department of Anaesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon, 2Department of Anaesthesiology and Pain Medicine, Gachon University, Gil Medical Center, Incheo...

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Autores principales:	Yoo JY, Kim JY, Kwak HJ, Lee DC, Kim GW, Lee SY, Chae YJ
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2016
Materias:	Analgesic opioid Remifentanil Elderly Extubation Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/0a8a082cae1a4981ac8cc19ac8207c9b
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spelling	oai:doaj.org-article:0a8a082cae1a4981ac8cc19ac8207c9b2021-12-02T07:34:18ZEffect-site concentration of remifentanil for preventing cough during emergence in elderly patients undergoing nasal surgery: a comparison with adult patients1178-1998https://doaj.org/article/0a8a082cae1a4981ac8cc19ac8207c9b2016-09-01T00:00:00Zhttps://www.dovepress.com/effect-site-concentration-of-remifentanil-for-preventing-cough-during--peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Ji Young Yoo,1 Jong Yeop Kim,1 Hyun Jeong Kwak,2 Dong Chul Lee,2 Go Wun Kim,1 Sook Young Lee,1 Yun Jeong Chae1 1Department of Anaesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon, 2Department of Anaesthesiology and Pain Medicine, Gachon University, Gil Medical Center, Incheon, Korea Purpose: Prevention of cough during emergence after nasal surgery is important for avoiding surgical site bleeding. We investigated the remifentanil effect-site concentration in 50% (EC50) of the elderly patients undergoing nasal surgery for smooth emergence without cough and compared it with that of adult patients.Methods: Twenty-two elderly (aged 65–80 years) and 25 adult patients (aged 20–60 years) with an American Society of Anesthesiologists physical status I/II undergoing nasal surgery were enrolled. Anesthesia was maintained with sevoflurane and remifentanil. Remifentanil EC50 and EC95 for preventing cough were determined using the modified Dixon’s up-and-down method and isotonic regression with bootstrapping approach. Recovery profiles were also recorded.Results: With Dixon’s up-and-down method, the EC50 of remifentanil in elderly patients (2.40±0.25 ng/mL) was not significantly different from that of adults (2.33±0.30 ng/mL) (P=0.687). With isotonic regression, the EC95 of remifentanil in elderly patients (3.32 [95% confidence interval: 3.06–3.38] ng/mL) was not significantly different from that of adults (3.30 [95% confidence interval: 2.96–3.37] ng/mL). However, eye opening time (14.1±3.8 vs 12.0±2.9 seconds), extubation time (17.2±4.1 vs 14.0±3.0 seconds), and postanesthesia care unit duration (44.5±7.6 vs 38.7±3.4 minutes) in elderly patients were significantly longer than those in adults (P<0.05).Conclusion: Remifentanil EC50 for preventing cough after nasal surgery with sevoflurane anesthesia did not differ between elderly and adult patients. However, delayed awakening and respiratory adverse events may warrant attention in elderly patients. Keywords: sevoflurane, cough, remifentanil, elderly, extubationYoo JYKim JYKwak HJLee DCKim GWLee SYChae YJDove Medical PressarticleAnalgesic opioidRemifentanilElderlyExtubationGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 11, Pp 1247-1252 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	Analgesic opioid Remifentanil Elderly Extubation Geriatrics RC952-954.6
spellingShingle	Analgesic opioid Remifentanil Elderly Extubation Geriatrics RC952-954.6 Yoo JY Kim JY Kwak HJ Lee DC Kim GW Lee SY Chae YJ Effect-site concentration of remifentanil for preventing cough during emergence in elderly patients undergoing nasal surgery: a comparison with adult patients
description	Ji Young Yoo,1 Jong Yeop Kim,1 Hyun Jeong Kwak,2 Dong Chul Lee,2 Go Wun Kim,1 Sook Young Lee,1 Yun Jeong Chae1 1Department of Anaesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon, 2Department of Anaesthesiology and Pain Medicine, Gachon University, Gil Medical Center, Incheon, Korea Purpose: Prevention of cough during emergence after nasal surgery is important for avoiding surgical site bleeding. We investigated the remifentanil effect-site concentration in 50% (EC50) of the elderly patients undergoing nasal surgery for smooth emergence without cough and compared it with that of adult patients.Methods: Twenty-two elderly (aged 65–80 years) and 25 adult patients (aged 20–60 years) with an American Society of Anesthesiologists physical status I/II undergoing nasal surgery were enrolled. Anesthesia was maintained with sevoflurane and remifentanil. Remifentanil EC50 and EC95 for preventing cough were determined using the modified Dixon’s up-and-down method and isotonic regression with bootstrapping approach. Recovery profiles were also recorded.Results: With Dixon’s up-and-down method, the EC50 of remifentanil in elderly patients (2.40±0.25 ng/mL) was not significantly different from that of adults (2.33±0.30 ng/mL) (P=0.687). With isotonic regression, the EC95 of remifentanil in elderly patients (3.32 [95% confidence interval: 3.06–3.38] ng/mL) was not significantly different from that of adults (3.30 [95% confidence interval: 2.96–3.37] ng/mL). However, eye opening time (14.1±3.8 vs 12.0±2.9 seconds), extubation time (17.2±4.1 vs 14.0±3.0 seconds), and postanesthesia care unit duration (44.5±7.6 vs 38.7±3.4 minutes) in elderly patients were significantly longer than those in adults (P<0.05).Conclusion: Remifentanil EC50 for preventing cough after nasal surgery with sevoflurane anesthesia did not differ between elderly and adult patients. However, delayed awakening and respiratory adverse events may warrant attention in elderly patients. Keywords: sevoflurane, cough, remifentanil, elderly, extubation
format	article
author	Yoo JY Kim JY Kwak HJ Lee DC Kim GW Lee SY Chae YJ
author_facet	Yoo JY Kim JY Kwak HJ Lee DC Kim GW Lee SY Chae YJ
author_sort	Yoo JY
title	Effect-site concentration of remifentanil for preventing cough during emergence in elderly patients undergoing nasal surgery: a comparison with adult patients
title_short	Effect-site concentration of remifentanil for preventing cough during emergence in elderly patients undergoing nasal surgery: a comparison with adult patients
title_full	Effect-site concentration of remifentanil for preventing cough during emergence in elderly patients undergoing nasal surgery: a comparison with adult patients
title_fullStr	Effect-site concentration of remifentanil for preventing cough during emergence in elderly patients undergoing nasal surgery: a comparison with adult patients
title_full_unstemmed	Effect-site concentration of remifentanil for preventing cough during emergence in elderly patients undergoing nasal surgery: a comparison with adult patients
title_sort	effect-site concentration of remifentanil for preventing cough during emergence in elderly patients undergoing nasal surgery: a comparison with adult patients
publisher	Dove Medical Press
publishDate	2016
url	https://doaj.org/article/0a8a082cae1a4981ac8cc19ac8207c9b
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Effect-site concentration of remifentanil for preventing cough during emergence in elderly patients undergoing nasal surgery: a comparison with adult patients

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