• Min Kyong Kim, Chong Wha Baek, Hyun Kang, Geun Joo Choi, Yong Hee Park, So Young Yang, Hwa Yong Shin, Yong Hun Jung, and Young Cheol Woo.
• Department of Anesthesiology and Pain Medicine, Chung-Ang University College of Medicine, 102 Heukseok-ro, Dongjak-gu, Seoul 156-755, Republic of Korea.
• J Clin Anesth. 2016 Feb 1; 28: 19-25.

Study ObjectiveTo compare recovery times and respiratory complications during emergence after deep extubation using either desflurane alone or a lower concentration of desflurane with remifentanil.DesignProspective randomized double-blind clinical trial.SettingIntraoperative.PatientsA total of 62 patients between the ages of 20 and 60 years with American Society of Anesthesiologists class I or II and who underwent low- to intermediate-risk surgery of 2- to 4-hour duration were enrolled.InterventionsRandomly assigned either 1.5 minimum alveolar concentration desflurane (group D; n = 31) or 1.0 minimum alveolar concentration of desflurane and 1.0 ng/mL effect-site concentration of remifentanil (group DR; n = 31).MeasurementsRecovery times, from the time of extubation to the time when the patients could breathe without assistance, were awake enough to maintain the airway independently, and exited the recovery room, as well as respiratory complications were compared between the groups.Main ResultsRecovery times were significantly reduced in the group DR (P < .001). The incidence of respiratory complications was also lower in group DR than in group D (48% vs 3.8%; P < .001).ConclusionsThe combined use of remifentanil while lowering the concentration of desflurane improves recovery profiles during emergence after deep extubation.Copyright © 2016 Elsevier Inc. All rights reserved.

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