Extubation under deep anesthesia; deep extubation can minimize many emergence phenomena but increases the risk of delayed recovery and respiratory complications.
Remifentanil is known to reduce coughing, nonpurposeful movement and tachycardia, when continuously used in low dosage during the emergence phase.
Remifentanil can also reduce the concentration of volatile anesthetics required for stable extubation.
The technique using 1 minimum alveolar concentration of desflurane with 1 ng/mL target-controlled infusion of remifentanil during deep extubation significantly reduces recovery time and respiratory complications.