Evaluation of chest wall rigidity
cough, desaturation, chest wall rigidity
ADVERSE EFFECTS, SECONDARY
After confirming loss of spontaneous breathing and achieving a target Ce of 3 ng/mL remifentanil, the development of remifentanil-induced chest wall rigidity was evaluated for 120 s while providing manual positive pressure ventilation without administration of a neuromuscular blocking agent. During the assessment, the fresh gas flow rate and inspired fraction of oxygen were set at 6 L/min and 0.5, respectively. An experienced anesthesiologist (Y. J. Oh) blinded to the study groups assessed the patients using a 3-point Likert scale (1 = Unlikely, 2 = Probable, and 3 = Definite) as follows: Grade 1 (Unlikely); no signs of chest wall rigidity during positive pressure ventilation; Grade 2 (Probable); increased inspiratory airway pressures required to deliver appropriate tidal volumes (6–8 mL/kg The primary outcome was the incidence of remifentanil-induced chest wall rigidity. The development of other adverse effects, such as desaturation and cough, during the intervention was also compared as secondary outcomes. Potential risk factors for the development of remifentanil-induced chest wall rigidity were also identified.