Comparison of the incidence and severity of cough after alfentanil and remifentanil injection.
BACKGROUND
Intravenous administration of fentanyl derivatives can induce cough paradoxically. This study examined the incidence and severity of cough after a bolus of alfentanil and remifentanil.


METHODS
Four hundred and sixty-five patients, aged 18-70 years, were allocated randomly to three groups to receive alfentanil 10 microg/kg, remifentanil 1 microg/kg or an equal volume of 0.9% saline intravenously over 10 s. Any episode of cough was classified as coughing and graded as mild (1-2), moderate (3-4) or severe (5 or more).


RESULTS
The overall incidence of cough was higher in the opioid groups than in the saline group. The remifentanil group [39/150 patients; 26.0% (95% CI, 19.6-33.6%)] showed a higher incidence than the alfentanil group [11/152 patients; 7.2% (95% CI, 0.4-12.6%)] (P<0.001). There was no significant difference in the severity of cough between the alfentanil group and the remifentanil group.


CONCLUSIONS
This study demonstrated that equipotent boluses of alfentanil and remifentanil induced coughing, even though the incidence of cough after alfentanil administration was lower than that after remifentanil administration.
Cho
H B
HB
Department of Anesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon, Korea.
Kwak
H J
HJ
Park
S Y
SY
Kim
J Y
JY
D000328:Adult; D000368:Aged; D015760:Alfentanil / Q000008:administration & dosage / Q000009:adverse effects*; D000768:Anesthesia, General; D003371:Cough / Q000139:chemically induced* / Q000453:epidemiology; D004311:Double-Blind Method; D017558:Elective Surgical Procedures; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D015994:Incidence; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D008959:Models, Neurological; D010880:Piperidines / Q000008:administration & dosage / Q000009:adverse effects*; D011229:Preanesthetic Medication; D000077208:Remifentanil; D012720:Severity of Illness Index
D010880:Piperidines; D015760:Alfentanil; D000077208:Remifentanil