Optimal Remifentanil Concentration and Thyroidectomy

Optimal Effect Site Remifentanil Concentration for Smooth Extubation After Thyroid Surgery

The study is aimed at determining the remifentanil effect site concentration suppressing the cough at extubation after surgical thyroidectomy, performed under remifentanil/desflurane based general anesthesia, expressed as median and 95th percentile effective dose.

Possible hemodynamic instability, respiratory depression or prolongation of awakening time are also sought.

Inclusion Criteria:

• 18<age<67
• 6 hrs fasting
• American society of anesthesiology (ASA) Physical Status I o II
• Informed consent

Exclusion Criteria:

• Absence of inclusion criteria
• Use of cough suppressors, angiotensin converting enzyme-inhibitors, sedatives 4 weeks before surgery
• Arhythmia, pacemaker or unstable cardiovascular disease
• Hepatic or renal failure
• Anticipated difficulty in airways management
• Chronic obstructive pulmonary disease (COPD), Asthma, increased risk for inhalation, airway infection in the previous 4 weeks;
• Smoker
• Obesity (BMI >35)
• Pregnancy
• Hypersensitivity to drugs administered for the study