Department of Anaesthesiology and Pain Medicine and Anaesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.
Anaesthesia. 2010 Sep;65(9):930-5. doi: 10.1111/j.1365-2044.2010.06450.x.
This randomised, double-blinded, controlled trial was designed to identify the optimal dose of remifentanil for cough suppression without adverse effects during emergence from sevoflurane-remifentanil anaesthesia for thyroidectomy. One hundred and four patients were randomly assigned to maintain target effect-site concentrations of remifentanil at 0 (control group), 1.0 (remifentail 1 group), or 1.5 ng.ml(-1) (remifentanil 1.5 group) during emergence. The incidence of coughing was lower in the remifentanil 1.5 group (31%) than in the control group (74%) or remifentanil 1 group (63%) (p = 0.0004). In addition, the severity of coughing during extubation was lower in the remifentanil 1.5 group (median (IQR [range]) 0 (0-1 [0-1]) than in the control group (1 (0-2 [0-3])) and remifentanil 1 group (1 (0-2 [0-3])) (p = 0.004). Haemodynamic changes were reduced, but emergence time and stay in the post-anaesthesia care unit was prolonged in the remifentanil 1.5 group. Maintaining the remifentanil effect-site concentration at 1.5 ng.ml(-1) during emergence from sevoflurane-remifentanil anaesthesia reduces the incidence and severity of coughing without serious adverse events and may provide haemodynamic stability in patients undergoing thyroidectomy. However, awakening may be delayed.
这项随机、双盲、对照试验旨在确定瑞芬太尼的最佳剂量，以在甲状腺切除术的七氟醚-瑞芬太尼麻醉苏醒期间抑制咳嗽而无不良反应。104 名患者被随机分配在苏醒期间维持瑞芬太尼的目标效应部位浓度为 0（对照组）、1.0（瑞芬太尼 1 组）或 1.5ng/ml（瑞芬太尼 1.5 组）。瑞芬太尼 1.5 组（31%）的咳嗽发生率低于对照组（74%）或瑞芬太尼 1 组（63%）（p=0.0004）。此外，瑞芬太尼 1.5 组（中位数（IQR[范围]）0（0-1[0-1]））在拔管时咳嗽的严重程度低于对照组（1（0-2[0-3]））和瑞芬太尼 1 组（1（0-2[0-3]））（p=0.004）。瑞芬太尼 1.5 组的血流动力学变化减少，但苏醒时间和麻醉后恢复室停留时间延长。在七氟醚-瑞芬太尼麻醉苏醒期间将瑞芬太尼效应部位浓度维持在 1.5ng/ml 可降低咳嗽的发生率和严重程度，而无严重不良事件，并可能为甲状腺切除术患者提供血流动力学稳定。然而，唤醒可能会延迟。
