S-Space College of Medicine/School of Medicine (의과대학/대학원) Anesthesiology and Pain Medicine (마취통증의학전공) Journal Papers (저널논문_마취통증의학전공)
Stepwise tapering of remifentanil at the end of surgery decreased postoperative pain and the need of rescue analgesics after thyroidectomy
- Issue Date
- BioMed Central
- BMC Anesthesiology, 15(1):46
- Anesthetic volatile-desflurane ; Analgesics opioid- remifentanil ; Complications-hyperalgesia
- This is an Open Access article distributed under the terms of the Creative
Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.
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.
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 0.3μg/kg/min until the end of surgery in patients of the control group (group A) whereas remifentanil was tapered gradually from 0.3 to 0.1μg/kg/min until the end of surgery for at least 30minutes in patients with group B. Pain scores (0–100 numerical rating scale, NRS), rescue analgesic requirements and adverse events were assessed at 30min, 2h, 6h, 12h, and 24h after operation.
There was a significant decrease in pain scores at 30min (20 [0–80] vs. 50 [0–100], P = 0.002) and 2h (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.
Tapering of remifentanil at the end of surgery decreased postoperative pain scores immediately after thyroidectomy with desflurane and high-dose remifentanil anesthesia.
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