Application via mechanical dropper alleviates sufentanil-induced cough: a prospective, randomized, single-blinded trial

Minqiang Liu,Xiangpeng Zhong,Yong Liu,Renliang He,Zhichao Li,Song Wang,Fengxian Li

doi:10.1186/s13063-019-3274-y

Abstract

BackgroundIt was reported that prolonging the injection time or diluting administration can reduce the incidence of opioid-induced cough. However, the incidence of sufentanil-induced cough (SIC) via a standardized infusion rate is unclear. A mechanical dropper is an infusion filtering device commonly used for intravenous degassing; it can also be used to administer special drugs due to its temporary storage and dilution effect. This study assesses the effectiveness of administration via mechanical dropper on SIC.MethodsTwo hundred patients undergoing general anesthesia were enrolled. Patients received sufentanil at a strength of 0.3 μg·kg− 1 either via T-connector (group C) or by mechanical dropper (group M) at 1 ml·s− 1. Cough severity was graded as none (0), mild (1–2), moderate (3–5), or severe (> 5), and the incidence of SIC was evaluated for 5 min after the start of sufentanil injection. Other adverse reactions such as hypotension, hypertension, bradycardia, tachycardia, hypoxemia, vomiting, and aspiration during the induction period of general anesthesia were also observed. The primary outcome was the incidence of SIC. The secondary outcomes were the severity of SIC and other adverse reactions.ResultsThe incidence of SIC in group M was significantly lower than that in group C (2% versus 21%, P = 0.000), and the prevalence of moderately severe coughing was also statistically different (none in group M versus 11% in group C, P = 0.001). However, there were no statistical differences in the incidence of other adverse reactions between two groups (P > 0.05).ConclusionSufentanil application via mechanical dropper can significantly alleviate the occurrence of SIC during the induction phase of total intravenous general anesthesia. This method is simple, safe, and reliable, and has wide prospective application for clinical use.Trial registrationChinese Clinical Trial Register, ChiCTR-IOR-17011561. Registered on 3 June 2017.

Highlights

It was reported that prolonging the injection time or diluting administration can reduce the incidence of opioid-induced cough
A previous study reported a reduction of fentanyl-induced cough via mechanical dropper of approximately 84% [17], so we assumed that this simple method would cause at least an 80% decrease in the incidence of sufentanil-induced cough (SIC)
A total of 247 patients undergoing general anesthesia were initially assessed for eligibility in this study from July 3, 2017 to December 15, 2017

Summary

Introduction

It was reported that prolonging the injection time or diluting administration can reduce the incidence of opioid-induced cough. A mechanical dropper is an infusion filtering device commonly used for intravenous degassing; it can be used to administer special drugs due to its temporary storage and dilution effect. This study assesses the effectiveness of administration via mechanical dropper on SIC. Opioid-induced cough (OIC) is a common phenomenon during the induction of general anesthesia, and is normally considered to be temporary and not serious [1]. Sufentanil is a potent opioid commonly used in clinical anesthesia for its strong analgesic property [6, 7]. The incidence of sufentanil-induced cough (SIC) during the induction of anesthesia has been reported by different studies as being in a range from 16 to 47% [8,9,10]. Developing a simple, effective, and nonpharmacological method to counter SIC would be of considerable clinical significance

Methods

Results

Discussion

Conclusion