Target controlled remifentanil infusion for smooth laryngeal mask airway removal during emergence from desflurane-remifentanil anesthesia.
OBJECTIVE
Administration of remifentanil can be a reliable method for preventing airway reflex responses during emergence. We therefore investigated the effect of maintaining target controlled infusion (TCI) of remifentanil for smooth cLMA removal during emergence from desflurane-remifentanil anaesthesia.


METHODS
Forty-one patients undergoing uretero-renoscopy under general anesthesia with desflurane and at 1-4 ng/ml TCI remifentanil infusion were randomly assigned to a control group (n = 20) or a remifentanil group (n = 21). At the end of the surgery, desflurane and remifentanil infusion were stopped in group C and remifentanil was maintained at the effect-site concentration of 1.5 ng/ml TCI in group R. When LMA removal was accomplished without coughing, teeth clenching, gross purposeful movements, breath holding, laryngospasm, and desaturation to SpO(2) less than 90%, removal was regarded as smooth (successful). The emergence and recovery profiles were also evaluated.


RESULTS
The incidence and number of complications (coughing, teeth clenching, gross purposeful movements, breath holding, laryngospasm, desaturation to SpO(2) <90%) were significantly higher in the control group than in the remifentanil group (p = 0.002).


CONCLUSIONS
Maintaining effect-site TCI of remifentanil at 1.5 ng/ml during emergence from anaesthesia enabled smooth removal of cLMA without any delay in recovery time.
Ministry of Health Diskapi Yildirim Beyazit Research and Training Hospital, Ankara, Turkey. derya_z@yahoo.com
Derya
D
Ozkan
Julide
J
Ergil
Alp
A
Alptekin
Nihan
N
Aktürk
Haluk
H
Gümüs
D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D018685:Anesthetics, Inhalation / Q000008:administration & dosage*; D000077335:Desflurane; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007530:Isoflurane / Q000008:administration & dosage / Q000031:analogs & derivatives*; D017214:Laryngeal Masks; D008297:Male; D008875:Middle Aged; D010880:Piperidines / Q000008:administration & dosage*; D011446:Prospective Studies; D000077208:Remifentanil
D000701:Analgesics, Opioid; D018685:Anesthetics, Inhalation; D010880:Piperidines; D000077335:Desflurane; D007530:Isoflurane; D000077208:Remifentanil