| Effect of low dose ketamine to prevent remifentanil-induced cough: a randomized, double-blind, placebo controlled trial. |
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Ji Young Kim, Jong Yeop Kim, Sung Yong Park, Wol Seon Jung, Hyun Jeong Kwak |
1Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea.
2Department of Anesthesiology and Pain Medicine, Ajou University College of Medicine, Suwon, Korea.
3Department of Anesthesiology and Pain Medicine, Gachon University of Medicine and Science, Gil Medical Center, Incheon, Korea. hyun615@gilhospital.com |
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| Abstract |
BACKGROUND
A reflex cough is often observed after an intravenous (IV) bolus of remifentanil. Since ketamine was reported to be effective in modulating the cough reflex, this prospective, randomized, double-blind, placebo-controlled study was designed to evaluate the efficacy of pretreatment with ketamine on remifentanil-induced cough.
METHODS
320 patients undergoing general anesthesia for elective surgery were randomly allocated into two groups to receive either IV ketamine 0.1 mg/kg (ketamine group, n = 156) or 0.9% saline (saline group, n = 154) 1 min before administration of remifentanil at a target effect-site concentration of 5 ng/ml. Severity of cough was graded (mild, 1-2; moderate, 3-4; and severe, 5 or >5).
RESULTS
The overall incidence of cough was significantly higher in the saline group (43/154 patients; 0.28, 95% CI 0.21, 0.36) than that in the ketamine group (18/156 patients; 0.12, 95% CI 0.07, 0.18) (P < 0.001). However, there was no significant difference in the severity and the onset time of cough between the groups.
CONCLUSIONS
IV ketamine 0.1 mg/kg one minute before remifentanil was effective in suppressing remifentanil-induced cough without affecting the severity and onset time. |
| Key Words:
Ketamine; Opioid-induced cough; Remifentanil |
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