COUGH INDUCED BY REMIFENTANIL TREATMENT WITH PROPOFOL DURING TARGET-CONTROLLED INFUSION ANESTHESIA
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Keywords
Remifentanil-induced cough, Propofol, Target-controlled infusion, Anaesthetic induction, Airway reflex suppression
Abstract
Background: Remifentanil is commonly used in the anaesthetic induction process but is commonly linked with the occurrence of opioid-related cough, which can be clinically complicated. It is known that Propofol inhibits the airway reflexes, but the interaction of Propofol and remifentanil-induced cough is not fully investigated. Methods: In this randomised trial, patients undergoing general anaesthesia were administered propofol at various target effect-site concentrations (0, 3.0, 4.5 or 6.0 μg/ ml -1) and remifentanil (4.0 ng/ ml -1) as target-controlled rate of IV infusion. Incidences, onset and severity of cough were established, haemodynamic variables and loss of responsiveness. The pharmacodynamic simulations using pharmacokinetics calculated plasma and effect-site remifentanil concentration during the cough onset. Findings Pretreatment with propofol effect-site concentration of 6.0 ug ml -1 had a significant effect on remifentanil-induced cough, but lower concentrations of propofol did not. The dose of remifentanil was similar between groups. Conclusion: Proper propofol pretreatment helps to avoid remifentanil-induced cough during the induction of anaesthesia probably due to a reduction in the disparity between plasma and effect-site concentrations.
References
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Dr. Akkina Sriram
Assistant Professor, Department of Anaesthesiology, Sri Lakshmi Narayana Institute of Medical Sciences & Hospital, Agaram Village, Puducherry – 605502
Dr. Navakanth
Assistant Professor, Department of Anaesthesiology, Sri Lakshmi Narayana Institute of Medical Sciences & Hospital, Osudu, Agaram Village, Koodapakkam Post, Puducherry – 605502
