Optimal Remifentanil Concentration and Thyroidectomy

University of Cagliari30 enrolled

Overview

The study is aimed at determining the remifentanil effect site concentration suppressing the cough at extubation after surgical thyroidectomy, performed under remifentanil/desflurane based general anesthesia, expressed as median and 95th percentile effective dose. Possible hemodynamic instability, respiratory depression or prolongation of awakening time are also sought.

Study Type

INTERVENTIONAL

Allocation

Purpose

OTHER

Masking

NONE

Enrollment

Conditions

Anesthesia

Interventions

Remifentanil Effect site concentrationOTHER

After skin suture, a predetermined Effect site remifentanil concentration will be achieved. Starting from 1.5 ng/ml in the first patient and increased or decreased by 0.2 ng/ml intervals based on the previous patient response: up if cough present, down otherwise ("Dixon's up and down" method).

Eligibility

Sex: ALLMin age: 18 YearsMax age: 67 Years

Medical Language ↔ Plain English

Inclusion Criteria: * 18\<age\<67 * 6 hrs fasting * American society of anesthesiology (ASA) Physical Status I o II * Informed consent Exclusion Criteria: * Absence of inclusion criteria * Use of cough suppressors, angiotensin converting enzyme-inhibitors, sedatives 4 weeks before surgery * Arhythmia, pacemaker or unstable cardiovascular disease * Hepatic or renal failure * Anticipated difficulty in airways management * Chronic obstructive pulmonary disease (COPD), Asthma, increased risk for inhalation, airway infection in the previous 4 weeks; * Smoker * Obesity (BMI \>35) * Pregnancy * Hypersensitivity to drugs administered for the study

Locations (1)

Policlinico Duilio Casula

Monserrato, Cagliari, Italy

Outcomes

Primary Outcomes

Cough

Any episode of sudden and violent abdominal contraction interrupting normal quite spontaneous or assisted ventilation would be accounted as "cough" and defines non-smooth extubation