The Effect of Continuous Remifentanil Infusion on the Airway Reactivity during Desflurane Inhalation

Abstract

Background: Because desflurane can cause airway reactivity, the use of opioids are aimed at its reduction. This study was designed to evaluate the effect of continuous remifentanil infusion on the airway reactivity during desflurane inhalation. Methods: 108 adult ASA physical status class I patients were enrolled in this study. The patients were divided into four groups.The breathing circuit was primed with 8 vol% desflurane in 3 L/min each of N2O and O2. Anesthesia was induced with 0.2 mg/kg of intravenous etomidate. After 2 minutes, either 20 ml/hr saline, or 0.15, 0.25 or 0.35μg/kg/min remifentanil, groups S, R1, R2 and R3, respectively, was infused. Each patient inhaled the gas mixture through a tight fitting facemask. During this period, the coughing, secretions, breathing hold, laryngospasms, excitatory movements and hemodynamics were measured. Results: The coughing, spasms, secretions and excitatory movements were significantly lower in the remifentanil than the saline infusion group (P ＜ 0.05). However, the breathing hold was significantly higher in group R3 (P ＜ 0.001). The mean arterial pressure and heart rate were more stable in groups R1 and R2. Conclusions: These results demonstrate that groups R1 and R2 had significantly reduced airway reactivity, with stabilize hemodynamics, during desflurane inhalation.