Comparison of sevoflurane and desflurane on effect-site concentration of remifentanil for preventing anesthetic emergence cough in elderly female patients undergoing laparoscopic cholecystectomy

Ha Yeon Kim,1 Yeo Rae Moon,2 Suhyun Seok,1 Bora Kim,1 Ji Eun Kim,1 Sook Young Lee1 1Department of Anesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon, Republic of Korea; 2Office of Biostatistics, Ajou Research Institute for Innovation Medicine, Ajou University School of Medi...

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Autores principales:	Kim HY, Moon YR, Seok S, Kim B, Kim JE, Lee SY
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2018
Materias:	cough elderly female inhalational anesthetics remifentanil Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/552009f97df2442cbbb30de12e1c36a8
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spelling	oai:doaj.org-article:552009f97df2442cbbb30de12e1c36a82021-12-02T07:11:10ZComparison of sevoflurane and desflurane on effect-site concentration of remifentanil for preventing anesthetic emergence cough in elderly female patients undergoing laparoscopic cholecystectomy1178-1998https://doaj.org/article/552009f97df2442cbbb30de12e1c36a82018-09-01T00:00:00Zhttps://www.dovepress.com/comparison-of-sevoflurane-and-desflurane-on-effect-site-concentration--peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Ha Yeon Kim,1 Yeo Rae Moon,2 Suhyun Seok,1 Bora Kim,1 Ji Eun Kim,1 Sook Young Lee1 1Department of Anesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon, Republic of Korea; 2Office of Biostatistics, Ajou Research Institute for Innovation Medicine, Ajou University School of Medicine, Suwon, Republic of Korea Purpose: Among inhalational anesthetics, desflurane is widely believed to provoke upper airway irritation including coughing and laryngospasm. Remifentanil has been generally used to prevent cough due to its unique pharmacodynamics. However, there was no study that compared optimal remifentanil effect-site concentration (Ce) to prevent emergence cough according to the type of inhalational agent in elderly female patients. Thus, we investigated the Ce of remifentanil for preventing cough during emergence from sevoflurane and desflurane anesthesia in elderly female patients. Methods: Forty-three female patients between 60 and 75 years of age undergoing laparoscopic cholecystectomy were randomly allocated to sevoflurane group (n=22) or desflurane group (n=21). The optimal remifentanil Ce using target-controlled infusion for 50% of patients (EC50) and 95% of patients (EC95) was assessed by Dixon’s up-and-down method or isotonic regression method with a bootstrapping approach. Results: By Dixon’s up-and-down method, the EC50 of remifentanil in sevoflurane group (2.08±0.47 ng/mL) was comparable with that in desflurane group (2.25±0.40 ng/mL) (P=0.385). The EC50 (83% CIs) and EC95 (95% CIs) by isotonic regression also did not show significant difference between two groups [2.06 (1.45–2.23) and 2.46 (2.35–2.48) ng/mL in sevoflurane group and 2.14 (1.45–2.56) and 2.88 (2.47–2.98) ng/mL in desflurane group, respectively]. Conclusion: There was no difference in the remifentanil Ce to prevent emergence cough between sevoflurane and desflurane anesthesia. Therefore, the clinicians may not need to adjust the remifentanil Ce to prevent emergence cough according to inhalational agents in elderly female patients. Keywords: aging, cough, inhalational anesthetics, opioid, womenKim HYMoon YRSeok SKim BKim JELee SYDove Medical Pressarticlecoughelderlyfemaleinhalational anestheticsremifentanilGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 13, Pp 1769-1777 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	cough elderly female inhalational anesthetics remifentanil Geriatrics RC952-954.6
spellingShingle	cough elderly female inhalational anesthetics remifentanil Geriatrics RC952-954.6 Kim HY Moon YR Seok S Kim B Kim JE Lee SY Comparison of sevoflurane and desflurane on effect-site concentration of remifentanil for preventing anesthetic emergence cough in elderly female patients undergoing laparoscopic cholecystectomy
description	Ha Yeon Kim,1 Yeo Rae Moon,2 Suhyun Seok,1 Bora Kim,1 Ji Eun Kim,1 Sook Young Lee1 1Department of Anesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon, Republic of Korea; 2Office of Biostatistics, Ajou Research Institute for Innovation Medicine, Ajou University School of Medicine, Suwon, Republic of Korea Purpose: Among inhalational anesthetics, desflurane is widely believed to provoke upper airway irritation including coughing and laryngospasm. Remifentanil has been generally used to prevent cough due to its unique pharmacodynamics. However, there was no study that compared optimal remifentanil effect-site concentration (Ce) to prevent emergence cough according to the type of inhalational agent in elderly female patients. Thus, we investigated the Ce of remifentanil for preventing cough during emergence from sevoflurane and desflurane anesthesia in elderly female patients. Methods: Forty-three female patients between 60 and 75 years of age undergoing laparoscopic cholecystectomy were randomly allocated to sevoflurane group (n=22) or desflurane group (n=21). The optimal remifentanil Ce using target-controlled infusion for 50% of patients (EC50) and 95% of patients (EC95) was assessed by Dixon’s up-and-down method or isotonic regression method with a bootstrapping approach. Results: By Dixon’s up-and-down method, the EC50 of remifentanil in sevoflurane group (2.08±0.47 ng/mL) was comparable with that in desflurane group (2.25±0.40 ng/mL) (P=0.385). The EC50 (83% CIs) and EC95 (95% CIs) by isotonic regression also did not show significant difference between two groups [2.06 (1.45–2.23) and 2.46 (2.35–2.48) ng/mL in sevoflurane group and 2.14 (1.45–2.56) and 2.88 (2.47–2.98) ng/mL in desflurane group, respectively]. Conclusion: There was no difference in the remifentanil Ce to prevent emergence cough between sevoflurane and desflurane anesthesia. Therefore, the clinicians may not need to adjust the remifentanil Ce to prevent emergence cough according to inhalational agents in elderly female patients. Keywords: aging, cough, inhalational anesthetics, opioid, women
format	article
author	Kim HY Moon YR Seok S Kim B Kim JE Lee SY
author_facet	Kim HY Moon YR Seok S Kim B Kim JE Lee SY
author_sort	Kim HY
title	Comparison of sevoflurane and desflurane on effect-site concentration of remifentanil for preventing anesthetic emergence cough in elderly female patients undergoing laparoscopic cholecystectomy
title_short	Comparison of sevoflurane and desflurane on effect-site concentration of remifentanil for preventing anesthetic emergence cough in elderly female patients undergoing laparoscopic cholecystectomy
title_full	Comparison of sevoflurane and desflurane on effect-site concentration of remifentanil for preventing anesthetic emergence cough in elderly female patients undergoing laparoscopic cholecystectomy
title_fullStr	Comparison of sevoflurane and desflurane on effect-site concentration of remifentanil for preventing anesthetic emergence cough in elderly female patients undergoing laparoscopic cholecystectomy
title_full_unstemmed	Comparison of sevoflurane and desflurane on effect-site concentration of remifentanil for preventing anesthetic emergence cough in elderly female patients undergoing laparoscopic cholecystectomy
title_sort	comparison of sevoflurane and desflurane on effect-site concentration of remifentanil for preventing anesthetic emergence cough in elderly female patients undergoing laparoscopic cholecystectomy
publisher	Dove Medical Press
publishDate	2018
url	https://doaj.org/article/552009f97df2442cbbb30de12e1c36a8
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Comparison of sevoflurane and desflurane on effect-site concentration of remifentanil for preventing anesthetic emergence cough in elderly female patients undergoing laparoscopic cholecystectomy

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