Anesthesia Emergence
Conditions
Keywords
emergence, remifentanil, recovery, desflurene
Brief summary
The number of obese and overweighted persons doubled since 1980. They are 600 million in 2014 all over the world. Obesity results in anatomical, physiological and pharmacological changes which represent a challenge for every anesthetist. Difficult airway increases by 30% with obesity and so awake extubation are the preferred technique. Coughing can be alleviated by opioid receptors which play a role in the cough reflex. Remifentanil may be useful as an ultra-short acting opioid and its effect swiftly and predictably disappears after cessation. An emergence cough is attenuated by remifentanil administered via continuous infusion (TCI), and the expected effective effect-site concentrations investigated have ranged from 1.5 to 2.5 ng.ml/L.
Detailed description
The investigators designed this study to examine the effect of different small doses of Remifentanil on the incidence of cough reflex during emergence from anesthesia in obese patients undergoing bariatric surgery. The investigators will study if these small doses will delay the recovery of the patient or not. The other expected side effects will be observed eg. Respiratory depression. Time to the first painkiller required will be registered
Interventions
DRUGNormal Saline
All the patient will be anesthetized using a standard anesthetic technique. One ml normal saline will be given
DRUGRemifentanil 0.1 ug/kg
All the patient will be anesthetized using a standard anesthetic technique. One ml normal saline contains 0.1 ug/kg Remifentanil will be given
DRUGRemifentanil 0.2 ug/kg
All the patient will be anesthetized using a standard anesthetic technique. One ml normal saline contains 0.2 ug/kg Remifentanil will be given
Sponsors
Assiut University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Caregiver, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
1. Age≥ 18 years 2. Subject has signed informed consent for bariatric laparoscopic surgery. 3. Subject must be ASA I or ASA II according to the American Society of Anesthetists classification.
Exclusion criteria
1. Age \< 18 years. 2. Smoking patient. 3. Hypertension. 4. Bronchial asthma. 5. Obstructive sleep apnea syndrome.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Changes in hemodynamic | within the first 24 hours | Mean blood pressure and heart rate will be recorded before surgery and combined with all the other study items at the end of surgery, at the extubation time, after 5 minutes in PACU, after 10 minutes in Postanesthesia Care Unit (PACU) and he last registered reading in PACU. |
| antitussive effect | within the first 24 hours | cough assessment at recovery time 0 no cough 1. single cough 2. cough episode less than five seconds or multiple coughs 3. sustained attack of cough lasts more than five seconds |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Respiratory depression | within the first 24 hours | In the postoperative period |
| Postoperative pain | within the first 24 hours | The duration from extubation till the first painkiller and pain severity using VAS at the extubation time will recorded |
Contacts
Primary ContactMohamed S Ali, MD
Backup ContactSayed K Abd-Elshafy, MD
Outcome results
None listed