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KMID : 0356920090560060624
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Korean Journal of Anesthesiology
2009 Volume.56 No. 6 p.624 ~ p.627
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Effect of low dose ketamine to prevent remifentanil-induced cough: a randomized, double-blind, placebo controlled trial
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Kim Ji-Young
Kim Jong-Yeop
Park Sung-Yong
Jung Wol-Seon
Kwak Hyun-Jeong
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Abstract
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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.
Conslusions: IV ketamine 0.1 mg/kg one minute before remifentanil was effective in suppressing remifentanil-induced cough without affecting the severity and onset time.
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KEYWORD
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Ketamine, Opioid-induced cough, Remifentanil
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