Abstract
Background & Objectives: Attenuation of cough reflex during emergence from anesthesia enables smooth recovery with less respiratory and cardiovascular complications [1]. We designed this study to examine the effect of small doses of remifentanil on the incidence of cough reflex during emergence from anesthesia in obese patients undergoing bariatric surgery. Materials & Methods: After local research ethical committee approval and patients’ written consent seventy two patients undergoing different bariatric procedures (lap sleeve gastrectomy, lap gastric banding) were randomly allocated into three equal groups (Group1, Placebo; Group 2, 0.1µg.kg-1 remifentanil and Group 3, 0.2µg.kg-1 remifentanil). Syringes prefilled by 1 ml saline with or without remifentanil (0.1µg.kg-1 or 0.2µg.kg-1) were given blindly at the end of surgery. All patients had a standard anesthetic technique. The severity of cough assessed on a four-level scale: 0, no cough; 1, single cough; 2, more than one episode of non-sustained cough; 3, sustained and repetitive cough [2]. Also, extubation time estimated from the time of drug administration to extubation. Results: The three groups were comparable as regard to age, sex, duration of surgery and BMI. Mean Extubation time were significantly longer in group 3 (5.85 min) compared with group 1 (3.18 min) and group 2 (4.6 min), as well as in group 2 compared with placebo (group1). The incidence of cough was significantly lower in both remifentanil groups versus placebo, while between remifentanil groups there was no significant difference in cough incidence before and after extubation (Table 1).Conclusion: doses of remifentanil (0.1 and 0.2 µg.kg-1) before extubation reduce the incidence of cough during emergence from anesthesia in obese patients undergoing bariatric surgery.
Published Version
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