The effect of lidocaine on remifentanil‐induced cough

Abstract

SummaryThis study was performed to investigate the incidence of remifentanil-induced cough and evaluate the efficacy of lidocaine on its prevention. Five-hundred patients, aged 18-70 years, were randomly allocated into two groups to receive either lidocaine 0.5 mg.kg )1 or 0.9% normal saline intravenously 1 min before remifentanil administration at a target effect-site concentration of 4 ng.ml )1 .

The incidence of cough induced by remifentanil during anesthetic induction was decreased by graded escalation of the remifentanil concentration

“…In the present study, when remifentanil's effect site concentration was set at 4.0 ng/ml, the incidence of coughing was 34%, which is slightly higher than that reported by Kim et al [2,3] who set the effect site concentration at 4.0 ng/ml and 5.0 ng/ml and the incidence of coughing was 27.6% and 27.9%, respectively. The difference is believed to be caused by the different characteristics of the subjects of the two studies.…”

“…There have been reports showing that smoking reduced the incidence of fentanyl-induced coughing [9,10]. Kim et al reported that the incidence of remifentanil induced coughing was lower in smokers than that in nonsmokers [2]. Therefore, the higher incidence of coughing in our study is considered to be due to the exclusion of smokers.…”

“…It is effective in reducing the perioperative hemodynamic, the autonomic responses and the somatic responses [1]. Although it was known that opioid suppresses the cough reflex during tracheal intubation, administrating a small amount of remifentanil was reported to cause coughing just like administering fentanyl [2]. The incident rate of remifentanil-induced coughing is about 27-28% [2,3].…”

“…Although it was known that opioid suppresses the cough reflex during tracheal intubation, administrating a small amount of remifentanil was reported to cause coughing just like administering fentanyl [2]. The incident rate of remifentanil-induced coughing is about 27-28% [2,3]. Coughing during anesthetic induction can increase the intracranial pressure, the intraocular pressure and the intraperitoneal pressure.…”

“…Many methods are used during anesthetic induction to reduce the occurrence of fentanyl-induced and remifentanil-induced coughing. The intravenous administration of selective beta-2 agonists (terbutaline and salbutamol), lidocaine and ketamine are known to reduce fentanyl-induced and remifentanil-induced coughing [2,3,5-8]. Lin et al [9] reported that the prolonged injection time and the slow administration of fentanyl decreased the incidence of fentanyl-induced coughing.…”