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The effect of injection speed on remifentanil-induced cough in children

Dae-Hee Kim1, Ji-Young Yoo1, Bong-Ki Moon1

  • 1Department of Anesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon, Korea.

Korean Journal of Anesthesiology
|October 11, 2014
PubMed

Insights

Slowly administering remifentanil over 60 seconds significantly reduces the incidence of remifentanil-induced cough (RIC) in pediatric patients. This method is recommended to suppress cough during anesthesia induction in children.

Area of Science:

  • Anesthesiology
  • Pediatric Anesthesia
  • Pharmacology

Background:

  • Remifentanil, a potent opioid, can cause cough during anesthesia induction.
  • Fentanyl congeners are known to elicit cough reflex.
  • The incidence and influencing factors of remifentanil-induced cough (RIC) in children require further investigation.

Purpose of the Study:

  • To determine the incidence of remifentanil-induced cough (RIC) in pediatric patients.
  • To evaluate the impact of remifentanil injection speed on the occurrence of RIC.
  • To establish optimal administration guidelines for remifentanil in children.

Main Methods:

  • A randomized study involving 120 pediatric patients (3-12 years) undergoing general anesthesia.
  • Patients were assigned to receive remifentanil 1.5 µg/kg over 30, 45, or 60 seconds.
  • Cough episodes were recorded and graded; hemodynamic parameters (MAP, HR, SpO2) were monitored.

Main Results:

  • The incidence of RIC was 33.3% (30s), 17.9% (45s), and 5.0% (60s).
  • A significantly lower incidence of RIC was observed with 60-second administration compared to 30-second administration (P = 0.001).
  • No significant differences in Mean Arterial Pressure (MAP), Heart Rate (HR), or SpO2 were noted between groups.

Conclusions:

  • Increasing remifentanil injection time from 30 to 60 seconds significantly reduces RIC incidence in children.
  • Slow intravenous administration of remifentanil over 60 seconds is recommended to mitigate cough during pediatric anesthesia induction.
  • This finding provides evidence-based practice for safer anesthetic management in pediatric patients.
Abstract

Keywords:
AnesthesiaCoughInjection speedRemifentanil

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