Effect of low dose ketamine to prevent remifentanil-induced cough: a randomized, double-blind, placebo controlled trial.
10.4097/kjae.2009.56.6.624
- Author:
Ji Young KIM
1
;
Jong Yeop KIM
;
Sung Yong PARK
;
Wol Seon JUNG
;
Hyun Jeong KWAK
Author Information
1. Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea.
- Publication Type:Randomized Controlled Trial ; Original Article
- Keywords:
Ketamine;
Opioid-induced cough;
Remifentanil
- MeSH:
Anesthesia, General;
Cough;
Humans;
Incidence;
Ketamine;
Piperidines;
Prospective Studies;
Reflex
- From:Korean Journal of Anesthesiology
2009;56(6):624-627
- CountryRepublic of Korea
- Language:English
-
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.
