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J Chest Surg

Published online March 10, 2021

Copyright © Journal of Chest Surgery.

Fentanyl versus Remifentanil for Cough Suppression and Recovery after Video-Assisted Thoracic Surgery

Hee Won Son, M.D.1 , Ji Min Lee, M.D.2 , Se Hun Park, M.D., Ph.D.1 , Yong Jic Lee, M.D., Ph.D.2 , Ji Mi Oh, M.D.1 , Su Kyung Hwang, M.D., Ph.D.2

Departments of 1Anesthesiology and Pain Medicine and 2Thoracic and Cardiovascular Surgery, Ulsan University Hospital, Ulsan, Korea

Correspondence to:Su Kyung Hwang
Tel 82-52-250-7140
Fax 82-52-250-8558
E-mail victorylina@gmail.com
ORCID
https://orcid.org/0000-0003-2759-2774

Received: October 12, 2020; Revised: December 8, 2020; Accepted: December 21, 2020

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: Various methods have been used to reduce postoperative pain after thoracic surgery. However, these methods may affect the patient’s respiratory response and delay recovery from anesthesia. We aimed to evaluate the effects of fentanyl and remifentanil during extubation after video-assisted thoracic surgery (VATS).
Methods: This study included 45 randomly-selected male patients who underwent VATS for pneumothorax between July 2011 and August 2012. We divided the participants into 3 groups: the F group, which received a bolus injection of 1.0 μg/kg of fentanyl; the R1 group, which received a 0.04 μg/kg/min remifentanil infusion; and the R2 group, which received a 0.08 μg/kg/min remifentanil infusion. Hemodynamics, pain, cough, consciousness level, and nausea were assessed for each group.
Results: The number and severity of coughs were lower in the R1 and R2 groups than in the F group, and there were no differences between the R1 and R2 groups. Respiratory depression and loss of consciousness were not observed in any of the patients, and there were no differences in hemodynamics.
Conclusion: In comparison with fentanyl, remifentanil did not result in a wide fluctuation of blood pressure and heart rate upon emergence from general anesthesia. Moreover, remifentanil contributed to cough suppression and postoperative pain control. Remifentanil seems to be a safe and effective analgesic after VATS.

Keywords: Anesthesia, Cough, Fentanyl, Remifentanil, Thoracic surgery

Article

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J Chest Surg

Published online March 10, 2021

Copyright © Journal of Chest Surgery.

Fentanyl versus Remifentanil for Cough Suppression and Recovery after Video-Assisted Thoracic Surgery

Hee Won Son, M.D.1 , Ji Min Lee, M.D.2 , Se Hun Park, M.D., Ph.D.1 , Yong Jic Lee, M.D., Ph.D.2 , Ji Mi Oh, M.D.1 , Su Kyung Hwang, M.D., Ph.D.2

Departments of 1Anesthesiology and Pain Medicine and 2Thoracic and Cardiovascular Surgery, Ulsan University Hospital, Ulsan, Korea

Correspondence to:Su Kyung Hwang
Tel 82-52-250-7140
Fax 82-52-250-8558
E-mail victorylina@gmail.com
ORCID
https://orcid.org/0000-0003-2759-2774

Received: October 12, 2020; Revised: December 8, 2020; Accepted: December 21, 2020

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: Various methods have been used to reduce postoperative pain after thoracic surgery. However, these methods may affect the patient’s respiratory response and delay recovery from anesthesia. We aimed to evaluate the effects of fentanyl and remifentanil during extubation after video-assisted thoracic surgery (VATS).
Methods: This study included 45 randomly-selected male patients who underwent VATS for pneumothorax between July 2011 and August 2012. We divided the participants into 3 groups: the F group, which received a bolus injection of 1.0 μg/kg of fentanyl; the R1 group, which received a 0.04 μg/kg/min remifentanil infusion; and the R2 group, which received a 0.08 μg/kg/min remifentanil infusion. Hemodynamics, pain, cough, consciousness level, and nausea were assessed for each group.
Results: The number and severity of coughs were lower in the R1 and R2 groups than in the F group, and there were no differences between the R1 and R2 groups. Respiratory depression and loss of consciousness were not observed in any of the patients, and there were no differences in hemodynamics.
Conclusion: In comparison with fentanyl, remifentanil did not result in a wide fluctuation of blood pressure and heart rate upon emergence from general anesthesia. Moreover, remifentanil contributed to cough suppression and postoperative pain control. Remifentanil seems to be a safe and effective analgesic after VATS.

Keywords: Anesthesia, Cough, Fentanyl, Remifentanil, Thoracic surgery

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