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Target controlled remifentanil infusion for smooth laryngeal mask airway removal during emergence from desflurane–remifentanil anesthesia

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Abstract

Purpose

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 SpO2 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 SpO2 <90%) were significantly higher in the control group than in the remifentanil group (p = 0.002).

Conclusion

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.

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Acknowledgments

This trial was supported by the Ministry of Health, Diskapi Yildirim Beyazit Research, and the Training Hospital Department of Anesthesiology, Ankara, Turkey.

Conflict of interest

No author has a conflict of interest.

Author information

Authors and Affiliations

  1. Ministry of Health Diskapi Yildirim Beyazit Research and Training Hospital, Anesthesiology and Reanimation Clinic, İrfan Bastug Cad, Diskapi, 06110, Ankara, Turkey

    Derya Özkan, Julide Ergil, Alp Alptekin, Nihan Aktürk & Haluk Gümüs

  2. Koru M Kavakli S, No: 4/44, Cayyolu, 06810, Ankara, Turkey

    Derya Özkan

Authors
  1. Derya Özkan
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  2. Julide Ergil
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  3. Alp Alptekin
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  4. Nihan Aktürk
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  5. Haluk Gümüs
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Corresponding author

Correspondence to Derya Özkan.

Additional information

ClinicalTrials.gov (NCT01303627).

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Özkan, D., Ergil, J., Alptekin, A. et al. Target controlled remifentanil infusion for smooth laryngeal mask airway removal during emergence from desflurane–remifentanil anesthesia. J Anesth 26, 369–374 (2012). https://doi.org/10.1007/s00540-012-1346-1

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  • DOI: https://doi.org/10.1007/s00540-012-1346-1

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