Cough Clinical Trial
Official title:
The Efficacy of Intravenous Lidocaine With Continuous Infusion of Remifentanil for Attenuating Double Lumen Tube Induced Cough During Emergence
Cough suppression during emergence and tracheal extubation from general anaesthesia has
become an important issue as part of patient safety. Cough arised from the mechanical
irritation of endotracheal tube and cuff could be accompanied by various adverse effects such
as laryngospasm, hypertension, tachycardia, arrhythmia and increase of intracranial,
intraocular, or intra-abdominal pressure.
Several cough-preventing strategies have been proposed for smooth emergence, such as opioids,
dexmedetomidine or lidocaine. Maintenance of remifentanil infusion during emergence has been
reported to be an effective method in reducing cough and cardiovascular change without delay
of recovery. In previous studies, the effetive effect-site concentraions for 95% of adults
(EC95) for preventing cough are a little different depending on anaestheic agent, type of
surgery and sex, ranged from 2.14 to 2.94 ng/ml. However, since most of these studies are for
sing lumen endotracheal tube, similar preventing effect would not be expected for double
lumen tube (DLT) because of its large diameter and long length. Another problem is higher
concentration of remifentanil more than 2.5 ng/ml could not guarantee the safety after
extubation. The efficacy of a single IV bolus of lidocaine for the prevention of cough has
been the subject of numerous trials.
Therefore, combined use of lidocaine and remifentanil could effectively prevent emergence
cough for DLT without the risk of high concentration of remifentanil.
n/a
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