title: Does the type of anesthetic agent affect remifentanil effect-site concentration for preventing endotracheal tube-induced cough during anesthetic emergence? Comparison of propofol, sevoflurane, and desflurane.
abstract: OBJECTIVE
  To investigate whether the type of anesthetic agent administered affects the antitussive effect of remifentanil.
  
  
  METHODS
  Prospective randomized study.
  
  
  METHODS
  Operating room of a university hospital.
  
  
  METHODS
  78 ASA physical status 1 and 2 women, aged 20 to 65 years, who were scheduled to undergo a thyroidectomy.
  
  
  METHODS
  Patients were randomly assigned to three groups to receive anesthesia with propofol (Group P), sevoflurane (Group S), or desflurane (Group D). The main anesthetics were titrated to maintain a target Bispectral Index for hypnosis of 40 to 60. Remifentanil was administered via effect-site target-controlled infusion (TCI). To determine the effective remifentanil effect-site concentration (Ce) to suppress coughing in each group, the up-and-down sequential allocation design was used.
  
  
  METHODS
  The half maximal effective concentration (EC50) values of remifentanil for preventing coughing in the groups were estimated using isotonic regression and compared among the groups.
  
  
  RESULTS
  The EC50 of remifentanil for cough suppression in Group P [1.60 ng/mL (98.3% CI, 0.92-1.75 ng/mL)] was statistically lower than in Group D [1.96 ng/mL (98.3% CI, 1.81-2.50 ng/mL)]. The EC50 in Group S was 1.75 ng/mL (98.3% CI, 1.39-2.13 ng/mL), which was higher than in Group P and lower than in Group D, but did not differ significantly from either group.
  
  
  CONCLUSIONS
  Remifentanil administration for cough suppression during emergence should be customized to the anesthetic agent.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Severance Hospital, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul 120-752, Korea.
authors.forename: Jae Hoon
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Anesthesiology and Pain Medicine, Severance Hospital, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul 120-752, Korea.
authors.forename: Seung Ho
authors.initials: SH
authors.lastname: Choi
authors.affiliation: Department of Anesthesiology and Pain Medicine, Severance Hospital, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul 120-752, Korea.
authors.forename: Yong Seon
authors.initials: YS
authors.lastname: Choi
authors.affiliation: Department of Anesthesiology and Pain Medicine, Severance Hospital, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul 120-752, Korea.
authors.forename: Bahn
authors.initials: B
authors.lastname: Lee
authors.affiliation: Department of Anesthesiology and Pain Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul 120-752, Korea.
authors.forename: Shi Joon
authors.initials: SJ
authors.lastname: Yang
authors.affiliation: Department of Anesthesiology and Pain Medicine, Severance Hospital, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul 120-752, Korea. Electronic address: leejeongrim@gmail.com.
authors.forename: Jeong-Rim
authors.initials: JR
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000762:Anesthesia Recovery Period; D018681:Anesthetics, General / Q000009:adverse effects*; D000996:Antitussive Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D003371:Cough / Q000209:etiology / Q000517:prevention & control*; D000077335:Desflurane; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects*; D007530:Isoflurane / Q000009:adverse effects / Q000031:analogs & derivatives; D008738:Methyl Ethers / Q000009:adverse effects; D008875:Middle Aged; D010880:Piperidines / Q000008:administration & dosage* / Q000627:therapeutic use; D011183:Postoperative Complications / Q000517:prevention & control*; D015742:Propofol / Q000009:adverse effects; D011446:Prospective Studies; D000077208:Remifentanil; D000077149:Sevoflurane; D013964:Thyroid Neoplasms / Q000601:surgery; D013965:Thyroidectomy; D055815:Young Adult
chemical_list: D018681:Anesthetics, General; D000996:Antitussive Agents; D008738:Methyl Ethers; D010880:Piperidines; D000077149:Sevoflurane; D000077335:Desflurane; D007530:Isoflurane; D000077208:Remifentanil; D015742:Propofol
keywords: Cough; Desflurane; Propofol; Remifentanil; Sevoflurane