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Sex Differences in Remifentanil Requirements for Preventing Cough during Anesthetic Emergence

PURPOSE: Target-controlled infusion (TCI) of remifentanil can suppress coughing during emergence from general anesthesia; nevertheless, previous studies under different clinical conditions recommend significantly different effective effect-site concentrations (effective Ce) of remifentanil for 50% o...

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Autores principales: Soh, Sarah, Park, Wyun Kon, Kang, Sang Wook, Lee, Bo Ra, Lee, Jeong Rim
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Yonsei University College of Medicine 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3990090/
https://www.ncbi.nlm.nih.gov/pubmed/24719152
http://dx.doi.org/10.3349/ymj.2014.55.3.807
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author Soh, Sarah
Park, Wyun Kon
Kang, Sang Wook
Lee, Bo Ra
Lee, Jeong Rim
author_facet Soh, Sarah
Park, Wyun Kon
Kang, Sang Wook
Lee, Bo Ra
Lee, Jeong Rim
author_sort Soh, Sarah
collection PubMed
description PURPOSE: Target-controlled infusion (TCI) of remifentanil can suppress coughing during emergence from general anesthesia; nevertheless, previous studies under different clinical conditions recommend significantly different effective effect-site concentrations (effective Ce) of remifentanil for 50% of patients (EC(50)). The differences among these studies include type of surgery and patient sex. In recent years, study of sex differences in regards to anesthetic pharmacology has drawn greater interest. Accordingly, we attempted to determine the effective Ce of remifentanil for preventing cough for each sex under the same clinical conditions. MATERIALS AND METHODS: Twenty female and 25 male ASA physical status I-II grade patients between the ages of 20 and 46 years who were undergoing thyroidectomy were enrolled in this study. The effective Ce of remifentanil for preventing cough was determined for each sex using the isotonic regression method with a bootstrapping approach, following Dixon's up-and-down method. RESULTS: Isotonic regression with a bootstrapping approach revealed that the estimated EC(50) of remifentanil for preventing coughing during emergence was significantly lower in females {1.30 ng/mL [83% confidence interval (CI), 1.20-1.47 ng/mL]} than in males [2.57 ng/mL (83% CI, 2.45-2.70 ng/mL)]. Mean EC(50) in females was also significantly lower than in males (1.23±0.21 ng/mL vs. 2.43±0.21 ng/mL, p<0.001). Mean arterial pressure, heart rate, and respiratory rate over time were not significantly different between the sexes. CONCLUSION: When using remifentanil TCI for cough prevention during anesthetic emergence, patient sex should be a considered for appropriate dosing.
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spelling pubmed-39900902014-05-01 Sex Differences in Remifentanil Requirements for Preventing Cough during Anesthetic Emergence Soh, Sarah Park, Wyun Kon Kang, Sang Wook Lee, Bo Ra Lee, Jeong Rim Yonsei Med J Original Article PURPOSE: Target-controlled infusion (TCI) of remifentanil can suppress coughing during emergence from general anesthesia; nevertheless, previous studies under different clinical conditions recommend significantly different effective effect-site concentrations (effective Ce) of remifentanil for 50% of patients (EC(50)). The differences among these studies include type of surgery and patient sex. In recent years, study of sex differences in regards to anesthetic pharmacology has drawn greater interest. Accordingly, we attempted to determine the effective Ce of remifentanil for preventing cough for each sex under the same clinical conditions. MATERIALS AND METHODS: Twenty female and 25 male ASA physical status I-II grade patients between the ages of 20 and 46 years who were undergoing thyroidectomy were enrolled in this study. The effective Ce of remifentanil for preventing cough was determined for each sex using the isotonic regression method with a bootstrapping approach, following Dixon's up-and-down method. RESULTS: Isotonic regression with a bootstrapping approach revealed that the estimated EC(50) of remifentanil for preventing coughing during emergence was significantly lower in females {1.30 ng/mL [83% confidence interval (CI), 1.20-1.47 ng/mL]} than in males [2.57 ng/mL (83% CI, 2.45-2.70 ng/mL)]. Mean EC(50) in females was also significantly lower than in males (1.23±0.21 ng/mL vs. 2.43±0.21 ng/mL, p<0.001). Mean arterial pressure, heart rate, and respiratory rate over time were not significantly different between the sexes. CONCLUSION: When using remifentanil TCI for cough prevention during anesthetic emergence, patient sex should be a considered for appropriate dosing. Yonsei University College of Medicine 2014-05-01 2014-04-01 /pmc/articles/PMC3990090/ /pubmed/24719152 http://dx.doi.org/10.3349/ymj.2014.55.3.807 Text en © Copyright: Yonsei University College of Medicine 2014 http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Soh, Sarah
Park, Wyun Kon
Kang, Sang Wook
Lee, Bo Ra
Lee, Jeong Rim
Sex Differences in Remifentanil Requirements for Preventing Cough during Anesthetic Emergence
title Sex Differences in Remifentanil Requirements for Preventing Cough during Anesthetic Emergence
title_full Sex Differences in Remifentanil Requirements for Preventing Cough during Anesthetic Emergence
title_fullStr Sex Differences in Remifentanil Requirements for Preventing Cough during Anesthetic Emergence
title_full_unstemmed Sex Differences in Remifentanil Requirements for Preventing Cough during Anesthetic Emergence
title_short Sex Differences in Remifentanil Requirements for Preventing Cough during Anesthetic Emergence
title_sort sex differences in remifentanil requirements for preventing cough during anesthetic emergence
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3990090/
https://www.ncbi.nlm.nih.gov/pubmed/24719152
http://dx.doi.org/10.3349/ymj.2014.55.3.807
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