Concentrations of Remifentanil for Extubation (REMEX)

March 16, 2016 updated by: LUIS ALBERTO TAFUR B, Seganest

Effect of Two Plasma Concentrations of Remifentanil Through Target Controlled Anesthesia on Frequency and Intensity of Coughing During Extubation: Randomized Controlled Clinical Trial

Condition of the State: (terminated, recruiting, etc.) Terminated

Study Design: Main Objective:

Compare the frequency and intensity of coughing at the time of extubation with two infusions of remifentanil that predict a plasma concentration (PC) of 3 - 4 and 2 - 3 ng/ml, through the technique of target controlled anesthesia

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Phase of the study:

Phase IV

Intervention:

Drug: U Extubation

Other Names:

Concentration 2 - 3 ng/ml Dose of remifentanil according to the randomization: Letter U between 2 - 3 ng/ml. The infusions that were used to reach the (PC) target were: Group U = 2 - 3 ng/ml. 20 years old - 6.0 mcg/Kg/h, 30 years old - 5.7 mcg/Kg/h, 40 years old - 5.3 mcg/kg/h, 50 years old - 5.0 mcg/kg/h, 60 years old - 4.6 mcg/kg/h, 70 years old - 4.3 mcg/kg/h, 80 years old - 4.0 mcg kg/h.

Drug: Extubation T

Other Names:

Concentration 3 - 4 ng/ml Dose of infusion of remifentanil to reach a (PC) 3 - 4 ng/ml, in the following manner: The assistant placed the infusion balloon in such a way that it could not be seen by the treating anesthesiologist, he proceeded to open the corresponding wrapping according to the consecutive which corresponds to the patient. The remifentanil dose was adjusted according to the randomization: Group T = 3 - 4 ng/ml. 20 years old - 9.0 mcg/Kg/h, 30 years old - 8.5 mcg/Kg/h, 40 years old - 8.0 mcg/kg/h, 50 years old - 7.5 mcg/kg/h, 60 years old - 7.0 mcg/kg/h, 70 years old - 6.5 mcg/kg/h, 80 years old - 6.0 mcg kg/h.

Number of arms:

2

Masking:

The patient had masking with regards to the anesthetic procedure from the unfamiliarity per se of the same and by agents used in this that induced anxiolysis and hypnosis.

To guarantee the masking to the viewer, which was the treating anesthesiologist, a nurse was trained in the adjustment of the infusion balloon. Ten minutes before concluding the procedure and by request of the anesthesiologist, the nurse proceeded to locate balloon in such a way that the infusion could not be seen by the anesthesiologist, then opened the envelope and adjusted the infusion according to the randomization (U) o (T). The evaluation of the cough, its intensity and the Ramsay were under the care of the anesthesiologist, who was unaware of the awakening infusion.

Allocation:

Two were allocated for the use: Concentration of remifentanil of 2 - 3 ng/ml (group U) and concentration of remifentanil of 3 - 4 ng/ml (group T).

Recruitment:

A patient was recruited between the period of January 2011 and July 2012.

Study Type

Interventional

Enrollment (Actual)

110

Phase

  • Phase 4

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Colombia
    • Valle del Cauca
      • Santiago de Cali, Valle del Cauca, Colombia, 288 00
        • Instituto Para Niños Ciegos y Sordos del Valle del Cauca

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years to 70 years (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • All patients aged 18-70 years
  • Risk Scale American Society of Anaesthesiologists physical status classification (ASA) I and II
  • Undergoing elective ear surgery

Exclusion Criteria:

  • Patients who are contraindicated remifentanil
  • Patients undergoing emergency surgery
  • Pulmonary Pathology (ASTHMA - COPD)
  • Index of body mass greater than 35
  • Background of respiratory failure three weeks prior to the procedure
  • Smokers

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Prevention
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Quadruple

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: Extubation U
Remifentanil concentration between 2 - 3 ng/ml.
Drug: Extubation U

Dose of remifentanil according to the randomization; the infusions that were used to reach the PC target were:

  • 20 years old - 6.0 mcg/Kg/h
  • 30 years old - 5.7 mcg/Kg/h
  • 40 years old - 5.3 mcg/kg/h
  • 50 years old - 5.0 mcg/kg/h
  • 60 years old - 4.6 mcg/kg/h
  • 70 years old - 4.3 mcg/kg/h
  • 80 years old - 4.0 mcg kg/h.
Other Names:
  • Ultiva
Experimental: Extubation T
Remifentanil concentration between 3 - 4 ng/ml
Drug: Extubation T

Dose of infusion of remifentanil to reach a PC 3 - 4 ng/ml, in the following manner:

The assistant placed the infusion balloon in such a way that it could not be seen by the treating anesthesiologist, he proceeded to open the corresponding wrapping according to the consecutive which corresponds to the patient.

The remifentanil dose was adjusted according to the randomization:

  • 20 years old - 9.0 mcg/Kg/h
  • 30 years old - 8.5 mcg/Kg/h
  • 40 years old - 8.0 mcg/kg/h
  • 50 years old - 7.5 mcg/kg/h
  • 60 years old - 7.0 mcg/kg/h
  • 70 years old - 6.5 mcg/kg/h
  • 80 years old - 6.0 mcg kg/h.
Other Names:
  • Ultiva

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Cough
Time Frame: It is evaluated by the scale of cough over a two hour period after surgery: is assessed at 5 minutes turned off the halogenated inhalation anesthetics, thereafter every minute until the patient responds to verbal stimulus and can be extubated

Number of episodes and duration of cough that occur when the patient responds to verbal stimulus and extubated.

Cough Scale

  • Grade 0 = No cough
  • Grade 1 = Mild (only episode of cough)
  • Grade 2 = Moderate (more than 1episode of cough during less than 5 seconds)
  • Grade 3 = Severe (More than one episode of cough that lasted more than 5 seconds or purposeless movements of the extremities).
It is evaluated by the scale of cough over a two hour period after surgery: is assessed at 5 minutes turned off the halogenated inhalation anesthetics, thereafter every minute until the patient responds to verbal stimulus and can be extubated

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Wake time.
Time Frame: During two hours after surgery, five minutes after turning off halogenated inhaled anesthetics, then every minute until the patient opens his eyes and is extubated.

When vaporizer where closed until the patient responds to the verbal stimulus and is extubated.

Defined as the time taken to open eyes after having turned off the halogenated inhalation anesthetics.
During two hours after surgery, five minutes after turning off halogenated inhaled anesthetics, then every minute until the patient opens his eyes and is extubated.
Ramsay scale at the time of extubation
Time Frame: During two hours after surgery, the estimated time period during which the event was assessed five (5) minutes after every minute, until answered

Ramsay scale: score objective system for measuring drug-induced sedation

  • Score 1: Anxious or restless or both
  • Score 2: Cooperative, orientated and tranquil
  • Score 3: Responding to commands
  • Score 4: Brisk response to stimulus
  • Score 5: Sluggish response to stimulus
  • Score 6: No response to stimulus
During two hours after surgery, the estimated time period during which the event was assessed five (5) minutes after every minute, until answered

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Seganest

Collaborators

Instituto Para Ninos Ciegos y Sordos del Valle del Cauca

Investigators

  • Principal Investigator: LUIS A TAFUR, MD, Seganest
  • Study Director: Eduardo Lema, MD, Seganest

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

January 1, 2011

Primary Completion (Actual)

January 1, 2011

Study Completion (Actual)

July 1, 2012

Study Registration Dates

First Submitted

August 27, 2013

First Submitted That Met QC Criteria

March 16, 2016

First Posted (Estimate)

March 17, 2016

Study Record Updates

Last Update Posted (Estimate)

March 17, 2016

Last Update Submitted That Met QC Criteria

March 16, 2016

Last Verified

March 1, 2016

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • SEGANEST

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

No

IPD Plan Description

The individual data of the participants (IPD) were only available to the ethics committee of the institution.

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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