Remifentanil infusion during emergence moderates hemodynamic and cough responses to the tracheal tube: A randomized controlled trial
Abstract Objective To examine the severity of cough and straining at the time of emergence from anesthesia. Design Double-blind randomized, placebo-controlled study. Setting University-affiliated hospital. Patients Sixty-two American Society of Anesthesiologists 2 patients undergoing craniotomy and...
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| Veröffentlicht in: | Journal of clinical anesthesia 2016-09, Vol.33, p.514-520 |
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| creator | Ghodraty, Mohammad Reza Hasani, Valiollah Bagheri-Aghdam, Amirhossein Zamani, Mohammad Mahdi Pournajafian, Alireza Rokhtabnak, Faranak Kholdebarin, Alireza Nader, Nader D |
| description | Abstract Objective To examine the severity of cough and straining at the time of emergence from anesthesia. Design Double-blind randomized, placebo-controlled study. Setting University-affiliated hospital. Patients Sixty-two American Society of Anesthesiologists 2 patients undergoing craniotomy and excision of supratentorial cerebral tumors. Intervention Intravenous infusion of remifentanil (REM) at 0.05 μg/kg/min or normal saline (NS) upon termination of the surgical procedure. Measurements Heart rate (HR) and mean arterial pressure (MAP) along with the frequency and severity of cough response (Modified Minogue Scale) to the endotracheal tube were recorded at different time points. The frequency of cough and straining was analyzed with χ2 tests. HRs and MAP were analyzed by repeated-measures analysis of variance between REM and NS groups. Main Results There was no case of significant cough in the REM group, and all of the patients in the NS group developed some extent of cough varying from mild retching to severe coughing episodes ( P < .001). Both the HR and MAPs were consistently lower in the REM group compared to the NS group. Conclusion Infusion of REM at the end of craniotomy procedures results in significant reduction of the frequency and severity of coughing and straining. Compared to placebo, REM moderates increases in MAP upon emergence from general anesthesia until the time of extubation. |
| doi_str_mv | 10.1016/j.jclinane.2015.09.001 |
| format | Article |
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Design Double-blind randomized, placebo-controlled study. Setting University-affiliated hospital. Patients Sixty-two American Society of Anesthesiologists 2 patients undergoing craniotomy and excision of supratentorial cerebral tumors. Intervention Intravenous infusion of remifentanil (REM) at 0.05 μg/kg/min or normal saline (NS) upon termination of the surgical procedure. Measurements Heart rate (HR) and mean arterial pressure (MAP) along with the frequency and severity of cough response (Modified Minogue Scale) to the endotracheal tube were recorded at different time points. The frequency of cough and straining was analyzed with χ2 tests. HRs and MAP were analyzed by repeated-measures analysis of variance between REM and NS groups. Main Results There was no case of significant cough in the REM group, and all of the patients in the NS group developed some extent of cough varying from mild retching to severe coughing episodes ( P < .001). Both the HR and MAPs were consistently lower in the REM group compared to the NS group. Conclusion Infusion of REM at the end of craniotomy procedures results in significant reduction of the frequency and severity of coughing and straining. Compared to placebo, REM moderates increases in MAP upon emergence from general anesthesia until the time of extubation.</description><identifier>ISSN: 0952-8180</identifier><identifier>EISSN: 1873-4529</identifier><identifier>DOI: 10.1016/j.jclinane.2015.09.001</identifier><identifier>PMID: 26603110</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Aged ; Analgesics, Opioid - administration & dosage ; Analgesics, Opioid - therapeutic use ; Anesthesia ; Anesthesia & Perioperative Care ; Anesthesia Recovery Period ; Arterial Pressure - drug effects ; Blood pressure ; Cough - prevention & control ; Coughing ; Craniotomy ; Double-Blind Method ; Edema ; Emergence ; Extubation ; Female ; Heart Rate - drug effects ; Hemodynamic ; Hemodynamics ; Hemodynamics - drug effects ; Humans ; Hypertension ; Informed consent ; Infusions, Intravenous ; Intubation, Intratracheal - adverse effects ; Male ; Medical personnel ; Middle Aged ; Narcotics ; Pain Medicine ; Patients ; Piperidines - administration & dosage ; Piperidines - therapeutic use ; Postoperative Complications - drug therapy ; Prospective Studies ; Remifentanil ; Straining ; Surgery ; Ventilation</subject><ispartof>Journal of clinical anesthesia, 2016-09, Vol.33, p.514-520</ispartof><rights>2015</rights><rights>Published by Elsevier Inc.</rights><rights>Copyright Elsevier Limited Sep 2016</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c484t-e3cf29a7b889a6052bfc54ac7f0b5680e73852d0a187a05ec0515f44a7dc39eb3</citedby><cites>FETCH-LOGICAL-c484t-e3cf29a7b889a6052bfc54ac7f0b5680e73852d0a187a05ec0515f44a7dc39eb3</cites><orcidid>0000-0002-5744-7319 ; 0000-0003-0062-8562</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0952818015002962$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65534</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26603110$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ghodraty, Mohammad Reza</creatorcontrib><creatorcontrib>Hasani, Valiollah</creatorcontrib><creatorcontrib>Bagheri-Aghdam, Amirhossein</creatorcontrib><creatorcontrib>Zamani, Mohammad Mahdi</creatorcontrib><creatorcontrib>Pournajafian, Alireza</creatorcontrib><creatorcontrib>Rokhtabnak, Faranak</creatorcontrib><creatorcontrib>Kholdebarin, Alireza</creatorcontrib><creatorcontrib>Nader, Nader D</creatorcontrib><title>Remifentanil infusion during emergence moderates hemodynamic and cough responses to the tracheal tube: A randomized controlled trial</title><title>Journal of clinical anesthesia</title><addtitle>J Clin Anesth</addtitle><description>Abstract Objective To examine the severity of cough and straining at the time of emergence from anesthesia. Design Double-blind randomized, placebo-controlled study. Setting University-affiliated hospital. Patients Sixty-two American Society of Anesthesiologists 2 patients undergoing craniotomy and excision of supratentorial cerebral tumors. Intervention Intravenous infusion of remifentanil (REM) at 0.05 μg/kg/min or normal saline (NS) upon termination of the surgical procedure. Measurements Heart rate (HR) and mean arterial pressure (MAP) along with the frequency and severity of cough response (Modified Minogue Scale) to the endotracheal tube were recorded at different time points. The frequency of cough and straining was analyzed with χ2 tests. HRs and MAP were analyzed by repeated-measures analysis of variance between REM and NS groups. Main Results There was no case of significant cough in the REM group, and all of the patients in the NS group developed some extent of cough varying from mild retching to severe coughing episodes ( P < .001). Both the HR and MAPs were consistently lower in the REM group compared to the NS group. Conclusion Infusion of REM at the end of craniotomy procedures results in significant reduction of the frequency and severity of coughing and straining. Compared to placebo, REM moderates increases in MAP upon emergence from general anesthesia until the time of extubation.</description><subject>Adult</subject><subject>Aged</subject><subject>Analgesics, Opioid - administration & dosage</subject><subject>Analgesics, Opioid - therapeutic use</subject><subject>Anesthesia</subject><subject>Anesthesia & Perioperative Care</subject><subject>Anesthesia Recovery Period</subject><subject>Arterial Pressure - drug effects</subject><subject>Blood pressure</subject><subject>Cough - prevention & control</subject><subject>Coughing</subject><subject>Craniotomy</subject><subject>Double-Blind Method</subject><subject>Edema</subject><subject>Emergence</subject><subject>Extubation</subject><subject>Female</subject><subject>Heart Rate - drug effects</subject><subject>Hemodynamic</subject><subject>Hemodynamics</subject><subject>Hemodynamics - drug effects</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Informed consent</subject><subject>Infusions, Intravenous</subject><subject>Intubation, Intratracheal - adverse effects</subject><subject>Male</subject><subject>Medical personnel</subject><subject>Middle Aged</subject><subject>Narcotics</subject><subject>Pain Medicine</subject><subject>Patients</subject><subject>Piperidines - administration & dosage</subject><subject>Piperidines - therapeutic use</subject><subject>Postoperative Complications - drug therapy</subject><subject>Prospective Studies</subject><subject>Remifentanil</subject><subject>Straining</subject><subject>Surgery</subject><subject>Ventilation</subject><issn>0952-8180</issn><issn>1873-4529</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqNkk2LFDEQhoMo7rj6F5aAFy_dVpJOf3gQl8UvWBD8OId0unomY3cyJumF8ewPN83sKuxFTymop95Q71uEXDAoGbD65b7cm8k67bDkwGQJXQnAHpANaxtRVJJ3D8kGOsmLlrVwRp7EuAeA3GCPyRmvaxCMwYb8-oyzHdEl7exErRuXaL2jwxKs21KcMWzRGaSzHzDohJHuMNdHp2drqHYDNX7Z7mjAePAu5n7yNO2QpqDNDvVE09LjK3pJQ4b9bH_iOuJS8NOUyxSsnp6SR6OeIj67fc_Jt3dvv159KK4_vf94dXldmKqtUoHCjLzTTd-2na5B8n40stKmGaGXdQvYiFbyAXT2QINEA5LJsap0MxjRYS_OyYuT7iH4HwvGpGYbDU5TttEvUbFWNLwTFeP_gbKKVdC1IqPP76F7vwSXF1kFmeC85lWm6hNlgo8x4KgOwc46HBUDtUaq9uouUrVGqqBTOdI8eHErv_QzDn_G7jLMwJsTgNm6G4tBRWPX0AYb0CQ1ePvvP17fk1gpa_T0HY8Y_-6jIlegvqyHtd4VkwC8q7n4DRCKy-s</recordid><startdate>20160901</startdate><enddate>20160901</enddate><creator>Ghodraty, Mohammad Reza</creator><creator>Hasani, Valiollah</creator><creator>Bagheri-Aghdam, Amirhossein</creator><creator>Zamani, Mohammad Mahdi</creator><creator>Pournajafian, Alireza</creator><creator>Rokhtabnak, Faranak</creator><creator>Kholdebarin, Alireza</creator><creator>Nader, Nader D</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>7QO</scope><scope>7U7</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>P64</scope><orcidid>https://orcid.org/0000-0002-5744-7319</orcidid><orcidid>https://orcid.org/0000-0003-0062-8562</orcidid></search><sort><creationdate>20160901</creationdate><title>Remifentanil infusion during emergence moderates hemodynamic and cough responses to the tracheal tube: A randomized controlled trial</title><author>Ghodraty, Mohammad Reza ; Hasani, Valiollah ; Bagheri-Aghdam, Amirhossein ; Zamani, Mohammad Mahdi ; Pournajafian, Alireza ; Rokhtabnak, Faranak ; Kholdebarin, Alireza ; Nader, Nader D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c484t-e3cf29a7b889a6052bfc54ac7f0b5680e73852d0a187a05ec0515f44a7dc39eb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Analgesics, Opioid - administration & dosage</topic><topic>Analgesics, Opioid - therapeutic use</topic><topic>Anesthesia</topic><topic>Anesthesia & Perioperative Care</topic><topic>Anesthesia Recovery Period</topic><topic>Arterial Pressure - drug effects</topic><topic>Blood pressure</topic><topic>Cough - prevention & control</topic><topic>Coughing</topic><topic>Craniotomy</topic><topic>Double-Blind Method</topic><topic>Edema</topic><topic>Emergence</topic><topic>Extubation</topic><topic>Female</topic><topic>Heart Rate - drug effects</topic><topic>Hemodynamic</topic><topic>Hemodynamics</topic><topic>Hemodynamics - drug effects</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Informed consent</topic><topic>Infusions, Intravenous</topic><topic>Intubation, Intratracheal - adverse effects</topic><topic>Male</topic><topic>Medical personnel</topic><topic>Middle Aged</topic><topic>Narcotics</topic><topic>Pain Medicine</topic><topic>Patients</topic><topic>Piperidines - administration & dosage</topic><topic>Piperidines - therapeutic use</topic><topic>Postoperative Complications - drug therapy</topic><topic>Prospective Studies</topic><topic>Remifentanil</topic><topic>Straining</topic><topic>Surgery</topic><topic>Ventilation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ghodraty, Mohammad Reza</creatorcontrib><creatorcontrib>Hasani, Valiollah</creatorcontrib><creatorcontrib>Bagheri-Aghdam, Amirhossein</creatorcontrib><creatorcontrib>Zamani, Mohammad Mahdi</creatorcontrib><creatorcontrib>Pournajafian, Alireza</creatorcontrib><creatorcontrib>Rokhtabnak, Faranak</creatorcontrib><creatorcontrib>Kholdebarin, Alireza</creatorcontrib><creatorcontrib>Nader, Nader D</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>Biotechnology Research Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><jtitle>Journal of clinical anesthesia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ghodraty, Mohammad Reza</au><au>Hasani, Valiollah</au><au>Bagheri-Aghdam, Amirhossein</au><au>Zamani, Mohammad Mahdi</au><au>Pournajafian, Alireza</au><au>Rokhtabnak, Faranak</au><au>Kholdebarin, Alireza</au><au>Nader, Nader D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Remifentanil infusion during emergence moderates hemodynamic and cough responses to the tracheal tube: A randomized controlled trial</atitle><jtitle>Journal of clinical anesthesia</jtitle><addtitle>J Clin Anesth</addtitle><date>2016-09-01</date><risdate>2016</risdate><volume>33</volume><spage>514</spage><epage>520</epage><pages>514-520</pages><issn>0952-8180</issn><eissn>1873-4529</eissn><abstract>Abstract Objective To examine the severity of cough and straining at the time of emergence from anesthesia. Design Double-blind randomized, placebo-controlled study. Setting University-affiliated hospital. Patients Sixty-two American Society of Anesthesiologists 2 patients undergoing craniotomy and excision of supratentorial cerebral tumors. Intervention Intravenous infusion of remifentanil (REM) at 0.05 μg/kg/min or normal saline (NS) upon termination of the surgical procedure. Measurements Heart rate (HR) and mean arterial pressure (MAP) along with the frequency and severity of cough response (Modified Minogue Scale) to the endotracheal tube were recorded at different time points. The frequency of cough and straining was analyzed with χ2 tests. HRs and MAP were analyzed by repeated-measures analysis of variance between REM and NS groups. Main Results There was no case of significant cough in the REM group, and all of the patients in the NS group developed some extent of cough varying from mild retching to severe coughing episodes ( P < .001). Both the HR and MAPs were consistently lower in the REM group compared to the NS group. Conclusion Infusion of REM at the end of craniotomy procedures results in significant reduction of the frequency and severity of coughing and straining. Compared to placebo, REM moderates increases in MAP upon emergence from general anesthesia until the time of extubation.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>26603110</pmid><doi>10.1016/j.jclinane.2015.09.001</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-5744-7319</orcidid><orcidid>https://orcid.org/0000-0003-0062-8562</orcidid></addata></record> |
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| subjects | Adult Aged Analgesics, Opioid - administration & dosage Analgesics, Opioid - therapeutic use Anesthesia Anesthesia & Perioperative Care Anesthesia Recovery Period Arterial Pressure - drug effects Blood pressure Cough - prevention & control Coughing Craniotomy Double-Blind Method Edema Emergence Extubation Female Heart Rate - drug effects Hemodynamic Hemodynamics Hemodynamics - drug effects Humans Hypertension Informed consent Infusions, Intravenous Intubation, Intratracheal - adverse effects Male Medical personnel Middle Aged Narcotics Pain Medicine Patients Piperidines - administration & dosage Piperidines - therapeutic use Postoperative Complications - drug therapy Prospective Studies Remifentanil Straining Surgery Ventilation |
| title | Remifentanil infusion during emergence moderates hemodynamic and cough responses to the tracheal tube: A randomized controlled trial |
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