title: Optimal effect-site concentration of remifentanil for inhibiting response to laryngeal mask airway removal during emergence.
abstract: OBJECTIVE
  This randomized, controlled, double-blind study was designed to determine the optimal dose of remifentanil for preventing complications associated with the removal of a laryngeal mask airway (LMA) without delaying emergence.
  
  
  METHODS
  This study randomly assigned 128 patients to remifentanil effect-site concentrations (Ce) of 0 ng/mL (group R0), 0.5 ng/mL (group R0.5), 1.0 ng/mL (group R1.0), and 1.5 ng/mL (group R1.5) during emergence. The emergence and recovery profiles were recorded. Adverse events such as coughing, airway obstruction, breath-holding, agitation, desaturation, nausea, and vomiting were also evaluated.
  
  
  RESULTS
  The number of patients with respiratory complications such as coughing and breath-holding was significantly lower in the R1.0 and R1.5 groups than in the R0 group (p<0.05). Emergence agitation also decreased in the R1.0 and R1.5 groups (p<0.0083). The time to LMA removal was significantly longer in the R1.5 group than in the other groups (p<0.05).
  
  
  CONCLUSIONS
  Maintaining a remifentanil Ce of 1.0 ng/mL during emergence may suppress adverse events such as coughing, breath-holding, and agitation following the removal of LMA without delayed awakening.
authors: Department of Anesthesiology and Pain Medicine, College of Medicine, Yeungnam University, Daegu, Korea. apsj0718@naver.com.
authors: Sang-Jin
authors: SJ
authors: Park
authors: Jong-Yoon
authors: JY
authors: Baek
authors: Department of Anesthesiology and Pain Medicine, College of Medicine, Yeungnam University, Daegu, Korea.
authors: Jong-Yun
authors: JY
authors: Baek
authors: Department of Anesthesiology and Pain Medicine, College of Medicine, Yeungnam University, Daegu, Korea.
authors: Dae-Lim
authors: DL
authors: Jee
mesh_terms: D000328:Adult; D058109:Airway Management / Q000379:methods*; D000762:Anesthesia Recovery Period; D018686:Anesthetics, Intravenous / Q000008:administration & dosage*; D003371:Cough / Q000517:prevention & control; D020878:Device Removal; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D017214:Laryngeal Masks / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010880:Piperidines / Q000008:administration & dosage*; D011183:Postoperative Complications / Q000517:prevention & control; D011595:Psychomotor Agitation; D000077208:Remifentanil; D014839:Vomiting / Q000517:prevention & control
chemical_list: D018686:Anesthetics, Intravenous; D010880:Piperidines; D000077208:Remifentanil
keywords: Emergence; laryngeal mask airway; remifentanil