title: Comparison of the effectiveness of lidocaine and salbutamol on coughing provoked by intravenous remifentanil during anesthesia induction.
abstract: BACKGROUND
  Coughing is a side effect of opioids that is rarely studied. Here, we evaluated the incidence of remifentanil induced coughing during anesthesia induction in an attempt to identify its risk factors and to examine the preventive effects of lidocaine and salbutamol.
  
  
  METHODS
  A total of 237 patients scheduled to undergo general anesthesia were allocated randomly into three groups. Group C received no medication, while Group L received 2% lidocaine at 0.5 mg/kg intravenously 1 minute prior to remifentanil infusion and Group S inhaled one metered aerosol puff of salbutamol 15 minutes prior to entering the operating room. Remifentanil was infused at 5 ng/ml by target controlled infusion and coughing was measured for five minutes and graded as none, mild, moderate, or severe based on the number of coughs.
  
  
  RESULTS
  The incidences of coughing were 30.4%, 25.3%, and 35.4% in Groups C, L, and S, respectively. The incidences, onset times, and severity of coughing did not differ significantly among groups. In addition, multivariate analysis showed that non-smoking and a lower body weight were risk factors of remifentanil-induced coughing (odds ratio, 8.13; P = 0.024, 1.11, and 0.004, respectively).
  
  
  CONCLUSIONS
  The incidence of remifentanil-induced coughing was 30%. A total of 0.5 mg/kg lidocaine and 1 metered aerosol puff of salbutamol did not prevent coughing. Non-smoking and low body weight were found to be risk factors of remifentanil-induced coughing.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Haeundae Paik Hospital, Inje University School of Medicine, Busan, Korea.
authors.forename: Si-Ra
authors.initials: SR
authors.lastname: Bang
authors.forename: Hyun Joo
authors.initials: HJ
authors.lastname: Ahn
authors.forename: Hyo Jin
authors.initials: HJ
authors.lastname: Kim
authors.forename: Gunn Hee
authors.initials: GH
authors.lastname: Kim
authors.forename: Jie Ae
authors.initials: JA
authors.lastname: Kim
authors.forename: Mikyung
authors.initials: M
authors.lastname: Yang
authors.forename: Jin-Kyoung
authors.initials: JK
authors.lastname: Kim
authors.forename: Hyun-Sung
authors.initials: HS
authors.lastname: Cho