Abstract: Objective: To compare the effects of remifentanil target-controlled infusion (TCI) and dexmedetomidine single-dose administration on the prevention of cough and hemodynamic instability during anesthetic emergence. Method: Ninety elective thyroidectomy patients were randomly assigned to control group (group C, n=30 ) , Remifentanil group (group R, n=30) or Dexmedetomidine group (group D, n=30) . Anesthesia was maintained with sevoflurane and effect-site target-controlled infusion of remifentanil. In group D, remifentanil was discontinued, and dexmedetomidine 0.5 μg/kg was given 10 minutes before the end of surgery. In group C and group D, remifentanil was discontinued at the end the surgery. In group R, remifentanil TCI at an concentration of 2.0 ng/mL was maintained during emergence until extubation. The cough score, hemodynamic values, and other recovery profiles were evaluated during the peri-extubation period. Result: During extubation, the proportion of patients with no cough or just a single cough was significantly higher in group R than in group D and group C (73.3% vs. 40% and 40%, p<0.05); MBP was lower in group R than in group C and group D (p<0.05); HR were lower in group R and group D than in group C (p<0.05). Conclusion: Remifentanil TCI prevent cough and blood pressure increase during emergence from general anesthesia more effectively than single-dose dexmedetomidine. Both of the drugs had the same effect on maintain heart rate stability , and had no respiratory suppression effect.

Key words: Remifentanil, Dexmedetomidine, Anesthesia recovery period, Cough.