Alfentanil suppresses coughing and agitation during emergence from isoflurane anesthesia.
OBJECTIVE
To evaluate the effectiveness of alfentanil in suppressing coughing and agitation during emergence from isoflurane anesthesia.


METHODS
Randomized, double-blind, placebo-controlled study.


METHODS
Operating rooms at a university medical center.


METHODS
34 healthy ASA physical status I and II adult patients scheduled to undergo oral surgical procedures.


METHODS
During emergence from anesthesia, patients received either alfentanil 15 micrograms/kg (in 10 ml) or saline (10 ml) when the end-tidal isoflurane concentration reached 0.3%.


RESULTS
Hemodynamic variables were measured at one-minute intervals following administration of the study medication. A blinded observer recorded the time for patients to spontaneously open their eyes and to follow commands after discontinuing the isoflurane. The occurrence of coughing and agitation prior to extubation was noted. Patients in the alfentanil treatment group exhibited a reduced incidence of coughing prior to extubation (6% vs. 83%, respectively) and a longer time interval until the onset of spontaneous movements (21.1 +/- 2.6 min vs. 14.6 +/- 1.7 min, respectively). The interval between the onset of movement and orientation was shorter in the alfentanil-treated patients, resulting in similar extubation times for both groups. Alfentanil administration was also associated with lower heart rate, systolic diastolic, and mean arterial pressure values during the emergence period.


CONCLUSIONS
Alfentanil decreased coughing, agitation, and cardiovascular stimulation during emergence from isoflurane anesthesia without prolonging the time of extubation.
Mendel
P
P
Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, Dallas 75235-9068, USA.
Fredman
B
B
White
P F
PF
D000328:Adult; D015760:Alfentanil / Q000627:therapeutic use*; D000758:Anesthesia; D001794:Blood Pressure / Q000187:drug effects; D003371:Cough / Q000188:drug therapy* / Q000209:etiology; D004311:Double-Blind Method; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007530:Isoflurane; D008297:Male; D009055:Mouth / Q000601:surgery; D011183:Postoperative Complications / Q000188:drug therapy*; D011595:Psychomotor Agitation / Q000188:drug therapy*
D015760:Alfentanil; D007530:Isoflurane