Efficacy of Two Bolus Doses of Remifentanil on the Incidence of Coughing During Emergence of Anesthesia
Comparison of the Efficacy of Two Bolus Doses of Remifentanil on the Incidence of Coughing During Emergence of Anesthesia.
This study is designed to compare the effects of two bolus doses of intravenous remifentanil given prior to the emergence of anesthesia:
- on the incidence of perioperative coughing
- on the time needed for the emergence of a desflurane-based anesthesia
- on the incidence of sore throat after extubation.
The investigators hypothesis is that the use of a higher remifentanil bolus dose (0.5 mcg/kg) given prior to emergence of a desflurane-based anesthesia will reduce the incidence of perioperative coughing when compared to a lower dose of remifentanil (0.25 mcg/kg).
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Emergence is an important period of general anesthesia during which several problems can occur. Coughing, hypertension, tachycardia and agitation have been observed during emergence of general anesthesia.
Most patients will cough during emergence. Different techniques and drugs have been studied to reduce coughing during emergence.
There is some evidence supporting the administration of intravenous opioids prior to emergence of general anesthesia to reduce perioperative coughing, agitation and haemodynamic stimulation. However, depending on the type of opioids given, this may delay the emergence from anesthesia. The effect of a remifentanil infusion given in combination with isoflurane as the volatile agent has been shown to reduce the incidence of perioperative coughing without delaying the emergence of anesthesia. The effect of a small bolus of remifentanil given prior to emergence to prevent perioperative coughing has yet to be studied.
Desflurane is a newer volatile agent allowing early recovery from anesthesia. This agent has led to earlier discharge and more rapid resumption of normal activities after surgery. However, an incidence of coughing around 70% has been reported after a desflurane-based anesthesia.
This study will compare the effects of two bolus doses of remifentanil (0.25 mcg/kg to 0.5 mcg/kg) when given prior to emergence to prevent perioperative coughing after a desflurane-based anesthesia.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Quebec
-
Montreal, Quebec, Canada, H2L 4M1
- Centre Hospitalier de l'Université de Montréal-Hôpital Notre-Dame
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patients aged 18-80 years
- Physical status 1-3
- Patients undergoing elective surgery under general anesthesia requiring endotracheal intubation (excluding head and neck surgery)
Exclusion Criteria:
- Current use of ACE inhibitors
- Chronic cough
- Asthma or severe pulmonary disease
- Pulmonary tract infection
- Anticipated difficult intubation
- Current use of opioids
- Current use of cough medicine
- Contraindication to remifentanil
- Pregnancy
- Symptomatic cardiac, renal or hepatic disease
Study Plan
How is the study designed?
Design Details
- Primary Purpose: PREVENTION
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: DOUBLE
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
EXPERIMENTAL: Remifentanil 0.25 mcg/kg
Administration of a bolus dose of remifentanil 0.25 mcg/kg before emergence of a desflurane-based anesthesia
|
Bolus dose of intravenous remifentanil 0.25 mcg/kg given once before emergence of general anesthesia
Bolus dose of intravenous remifentanil 0.5 mcg/kg given once before emergence of general anesthesia
|
|
ACTIVE_COMPARATOR: Remifentanil 0.5 mcg/kg
Administration of a bolus dose of remifentanil 0.5 mcg/kg before emergence of a desflurane-based anesthesia
|
Bolus dose of intravenous remifentanil 0.25 mcg/kg given once before emergence of general anesthesia
Bolus dose of intravenous remifentanil 0.5 mcg/kg given once before emergence of general anesthesia
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Incidence of coughing during emergence and the first ten minutes after extubation
Time Frame: From emergence until 10 minutes after extubation
|
From emergence until 10 minutes after extubation
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Time elapsed between the bolus dose of remifentanil and extubation
Time Frame: Assessed at emergence of general anesthesia
|
Assessed at emergence of general anesthesia
|
|
Incidence of sore throat one hour after extubation
Time Frame: Assessed one hour after extubation
|
Assessed one hour after extubation
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (ACTUAL)
Primary Completion
Study Completion (ACTUAL)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (ESTIMATE)
First Posted
Study Record Updates
Last Update Posted (ESTIMATE)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- NM 2012-002
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