Sex-related differences in effect-site concentration of remifentanil for preventing anesthetic emergence cough in elderly patients

Sook Young Lee, Yun Yong Jeong, Byung Ho Lee, Ji Eun Kim Department of Anesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon, Republic of Korea Purpose: Cough on anesthetic emergence should be prevented considering its dangerous complications. Target-controlled infusion (TCI)...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Lee SY, Jeong YY, Lee BH, Kim JE
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2018
Materias:	effect-site concentration elderly patients emergence cough remifentanil sex difference Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/e11baf4a4eb74a7b9be71baf7e914722
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:e11baf4a4eb74a7b9be71baf7e914722
record_format	dspace
spelling	oai:doaj.org-article:e11baf4a4eb74a7b9be71baf7e9147222021-12-02T03:58:27ZSex-related differences in effect-site concentration of remifentanil for preventing anesthetic emergence cough in elderly patients1178-1998https://doaj.org/article/e11baf4a4eb74a7b9be71baf7e9147222018-01-01T00:00:00Zhttps://www.dovepress.com/sex-related-differences-in-effect-site-concentration-of-remifentanil-f-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Sook Young Lee, Yun Yong Jeong, Byung Ho Lee, Ji Eun Kim Department of Anesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon, Republic of Korea Purpose: Cough on anesthetic emergence should be prevented considering its dangerous complications. Target-controlled infusion (TCI) of remifentanil can reduce emergence cough effectively, and sex-related differences in effect-site concentration (Ce) of remifentanil have been evaluated in young patients. In this study, we determined the Ce of remifentanil for preventing emergence cough following extubation in male and female elderly patients and evaluated the sex-related difference.Patients and methods: Twenty-three male and 22 female elderly patients aged between 60 and 75 years were enrolled. Anesthesia was maintained with sevoflurane and remifentanil TCI. The Ce of remifentanil for preventing emergence cough was determined for each sex using isotonic regression method with a bootstrapping approach, following Dixon’s up-and-down method.Results: The Ce of remifentanil for preventing emergence cough in 50% (EC50) and 95% (EC95) of the population was significantly lower in females than in males. Isotonic regression revealed the EC50 (83% confidence interval [CI]) of remifentanil was 1.67 (1.55–1.83) ng/mL in females and 2.60 (2.29–2.91) ng/mL in males. The EC95 (95% CI) of remifentanil was 2.30 (2.02–2.62) ng/mL in females and 3.41 (3.27–3.58) ng/mL in males. Dixon’s up-and-down method indicated that the mean EC50 in females was lower than in males (1.56±0.26 ng/mL vs 2.56±0.37 ng/mL, P<0.001).Conclusion: The remifentanil requirement for preventing emergence cough was lower in female than in male elderly patients, indicative of sex-related differences in Ce of remifentanil. Sex should be considered when using remifentanil TCI for preventing emergence cough in elderly patients. Keywords: effect-site concentration, elderly patients, emergence cough, remifentanil, sex differenceLee SYJeong YYLee BHKim JEDove Medical Pressarticleeffect-site concentrationelderly patientsemergence coughremifentanilsex differenceGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 13, Pp 81-89 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	effect-site concentration elderly patients emergence cough remifentanil sex difference Geriatrics RC952-954.6
spellingShingle	effect-site concentration elderly patients emergence cough remifentanil sex difference Geriatrics RC952-954.6 Lee SY Jeong YY Lee BH Kim JE Sex-related differences in effect-site concentration of remifentanil for preventing anesthetic emergence cough in elderly patients
description	Sook Young Lee, Yun Yong Jeong, Byung Ho Lee, Ji Eun Kim Department of Anesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon, Republic of Korea Purpose: Cough on anesthetic emergence should be prevented considering its dangerous complications. Target-controlled infusion (TCI) of remifentanil can reduce emergence cough effectively, and sex-related differences in effect-site concentration (Ce) of remifentanil have been evaluated in young patients. In this study, we determined the Ce of remifentanil for preventing emergence cough following extubation in male and female elderly patients and evaluated the sex-related difference.Patients and methods: Twenty-three male and 22 female elderly patients aged between 60 and 75 years were enrolled. Anesthesia was maintained with sevoflurane and remifentanil TCI. The Ce of remifentanil for preventing emergence cough was determined for each sex using isotonic regression method with a bootstrapping approach, following Dixon’s up-and-down method.Results: The Ce of remifentanil for preventing emergence cough in 50% (EC50) and 95% (EC95) of the population was significantly lower in females than in males. Isotonic regression revealed the EC50 (83% confidence interval [CI]) of remifentanil was 1.67 (1.55–1.83) ng/mL in females and 2.60 (2.29–2.91) ng/mL in males. The EC95 (95% CI) of remifentanil was 2.30 (2.02–2.62) ng/mL in females and 3.41 (3.27–3.58) ng/mL in males. Dixon’s up-and-down method indicated that the mean EC50 in females was lower than in males (1.56±0.26 ng/mL vs 2.56±0.37 ng/mL, P<0.001).Conclusion: The remifentanil requirement for preventing emergence cough was lower in female than in male elderly patients, indicative of sex-related differences in Ce of remifentanil. Sex should be considered when using remifentanil TCI for preventing emergence cough in elderly patients. Keywords: effect-site concentration, elderly patients, emergence cough, remifentanil, sex difference
format	article
author	Lee SY Jeong YY Lee BH Kim JE
author_facet	Lee SY Jeong YY Lee BH Kim JE
author_sort	Lee SY
title	Sex-related differences in effect-site concentration of remifentanil for preventing anesthetic emergence cough in elderly patients
title_short	Sex-related differences in effect-site concentration of remifentanil for preventing anesthetic emergence cough in elderly patients
title_full	Sex-related differences in effect-site concentration of remifentanil for preventing anesthetic emergence cough in elderly patients
title_fullStr	Sex-related differences in effect-site concentration of remifentanil for preventing anesthetic emergence cough in elderly patients
title_full_unstemmed	Sex-related differences in effect-site concentration of remifentanil for preventing anesthetic emergence cough in elderly patients
title_sort	sex-related differences in effect-site concentration of remifentanil for preventing anesthetic emergence cough in elderly patients
publisher	Dove Medical Press
publishDate	2018
url	https://doaj.org/article/e11baf4a4eb74a7b9be71baf7e914722
work_keys_str_mv	AT leesy sexrelateddifferencesineffectsiteconcentrationofremifentanilforpreventinganestheticemergencecoughinelderlypatients AT jeongyy sexrelateddifferencesineffectsiteconcentrationofremifentanilforpreventinganestheticemergencecoughinelderlypatients AT leebh sexrelateddifferencesineffectsiteconcentrationofremifentanilforpreventinganestheticemergencecoughinelderlypatients AT kimje sexrelateddifferencesineffectsiteconcentrationofremifentanilforpreventinganestheticemergencecoughinelderlypatients
_version_	1718401523440943104

Sex-related differences in effect-site concentration of remifentanil for preventing anesthetic emergence cough in elderly patients

Ejemplares similares