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Stepwise tapering of remifentanil at the end of surgery decreased postoperative pain and the need of rescue analgesics after thyroidectomy.

Han SS, Do SH, Kim TH, Choi WJ, Yun JS, Ryu JH - BMC Anesthesiol (2015)

Bottom Line: Pain scores (0-100 numerical rating scale, NRS), rescue analgesic requirements and adverse events were assessed at 30 min, 2 h, 6 h, 12 h, and 24 h after operation.There were no significant differences in adverse events between the two groups.Clinical Research information Service (CRiS, registration number KCT0000589).

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology & Pain Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea. hss9438@empal.com.

ABSTRACT

Background: This study was designed to investigate whether stepwise tapering of remifentanil at the end of surgery could decrease postoperative pain scores and requirements of rescue analgesics after remifentanil-desflurane anesthesia in patients with thyroidectomy.

Methods: Sixty two patients undergoing thyroidectomy under general anesthesia were randomly allocated into two groups. All patients were anesthetised with desflurane and high-dose remifentanil. Remifentnail was infused at the rate of 0.3 μg/kg/min until the end of surgery in patients of the control group (group A) whereas remifentanil was tapered gradually from 0.3 to 0.1 μg/kg/min until the end of surgery for at least 30 minutes in patients with group B. Pain scores (0-100 numerical rating scale, NRS), rescue analgesic requirements and adverse events were assessed at 30 min, 2 h, 6 h, 12 h, and 24 h after operation.

Results: There was a significant decrease in pain scores at 30 min (20 [0-80] vs. 50 [0-100], P = 0.002) and 2 h (30 [10-60] vs. 40 [20-80], P = 0.018) after surgery in group B compared with group A. In addition, rescue analgesics are less required in group B than in group A postoperatively (2 [1-3] vs. 3 [2,3], P = 0.039). There were no significant differences in adverse events between the two groups.

Conclusions: Tapering of remifentanil at the end of surgery decreased postoperative pain scores immediately after thyroidectomy with desflurane and high-dose remifentanil anesthesia.

Trial registration: Clinical Research information Service (CRiS, registration number KCT0000589).

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Related in: MedlinePlus

End-tidal concentration of desflurane during the operation. Values are given as mean (SD). A group: no tapering group, B group: tapering group.
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Fig2: End-tidal concentration of desflurane during the operation. Values are given as mean (SD). A group: no tapering group, B group: tapering group.

Mentions: No significant difference was observed in the end-tidal concentration of desflurane between the two groups (Figure 2). There was statistically significant correlation between the end-tidal concentration of desflurane at the stop of remifentanil and awake time (P = 0.002). No significant differences were observed in other adverse events including nausea, vomiting, shivering, headache, dizziness and drowsiness after surgery (Table 3).Figure 2


Stepwise tapering of remifentanil at the end of surgery decreased postoperative pain and the need of rescue analgesics after thyroidectomy.

Han SS, Do SH, Kim TH, Choi WJ, Yun JS, Ryu JH - BMC Anesthesiol (2015)

End-tidal concentration of desflurane during the operation. Values are given as mean (SD). A group: no tapering group, B group: tapering group.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4404040&req=5

Fig2: End-tidal concentration of desflurane during the operation. Values are given as mean (SD). A group: no tapering group, B group: tapering group.
Mentions: No significant difference was observed in the end-tidal concentration of desflurane between the two groups (Figure 2). There was statistically significant correlation between the end-tidal concentration of desflurane at the stop of remifentanil and awake time (P = 0.002). No significant differences were observed in other adverse events including nausea, vomiting, shivering, headache, dizziness and drowsiness after surgery (Table 3).Figure 2

Bottom Line: Pain scores (0-100 numerical rating scale, NRS), rescue analgesic requirements and adverse events were assessed at 30 min, 2 h, 6 h, 12 h, and 24 h after operation.There were no significant differences in adverse events between the two groups.Clinical Research information Service (CRiS, registration number KCT0000589).

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology & Pain Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea. hss9438@empal.com.

ABSTRACT

Background: This study was designed to investigate whether stepwise tapering of remifentanil at the end of surgery could decrease postoperative pain scores and requirements of rescue analgesics after remifentanil-desflurane anesthesia in patients with thyroidectomy.

Methods: Sixty two patients undergoing thyroidectomy under general anesthesia were randomly allocated into two groups. All patients were anesthetised with desflurane and high-dose remifentanil. Remifentnail was infused at the rate of 0.3 μg/kg/min until the end of surgery in patients of the control group (group A) whereas remifentanil was tapered gradually from 0.3 to 0.1 μg/kg/min until the end of surgery for at least 30 minutes in patients with group B. Pain scores (0-100 numerical rating scale, NRS), rescue analgesic requirements and adverse events were assessed at 30 min, 2 h, 6 h, 12 h, and 24 h after operation.

Results: There was a significant decrease in pain scores at 30 min (20 [0-80] vs. 50 [0-100], P = 0.002) and 2 h (30 [10-60] vs. 40 [20-80], P = 0.018) after surgery in group B compared with group A. In addition, rescue analgesics are less required in group B than in group A postoperatively (2 [1-3] vs. 3 [2,3], P = 0.039). There were no significant differences in adverse events between the two groups.

Conclusions: Tapering of remifentanil at the end of surgery decreased postoperative pain scores immediately after thyroidectomy with desflurane and high-dose remifentanil anesthesia.

Trial registration: Clinical Research information Service (CRiS, registration number KCT0000589).

Show MeSH
Related in: MedlinePlus