scholarly journals A small dose of remifentanil pretreatment suppresses sufentanil-induced cough during general anesthesia induction: a randomized, double-blind, placebo-controlled trial

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Wendong Lin ◽  
Jiehao Sun ◽  
Shuying Fu
Keyword(s):  
General Anesthesia ◽  
Small Dose ◽  
Controlled Trial ◽  
Anesthesia Induction ◽  
Double Blind ◽  
Double Blind Placebo

scholarly journals A small dose of remifentanil pretreatment suppresses sufentanil-induced cough during general anesthesia induction: a randomized, double-blind, placebo-controlled trial

2019 ◽  
Author(s):  
Wendong Lin ◽  
Jiehao Sun ◽  
Shuying Fu
Keyword(s):  
General Anesthesia ◽  
Small Dose ◽  
Elective Surgery ◽  
Controlled Trial ◽  
Inhibitory Effect ◽  
Control Group ◽  
Anesthesia Induction ◽  
Double Blind ◽  
Prospective Randomized Controlled Trial ◽  
Size Groups

Abstract Background: Intravenous use of sufentanil can elicit cough. This study aimed to evaluate the inhibitory effect of pre-injection of a mall dose of remifentanil on sufentanil-induced cough during the induction of general anesthesia. Methods: This prospective, randomized, controlled trial was conducted from January 10, 2019 to March 01, 2019. A total of 100 patients undergoing elective surgery under general anesthesia were enrolled, and at last 84 patients were included and randomly allocated into two equal size groups (n=42): Patients in the Remifentanil group (R group) received an intravenous infusion of remifentanil 0.3 µg/kg (diluted to 2 ml) 1 minute before sufentanil injection; patients in the Control group (C group) received 2 ml of normal saline (NS) at the same time point. Injections of patients in both groups were completed within 5 seconds. Then, sufentanil 0.5 µg/kg was injected within 5 seconds and the number of coughs that occurred within 1 minute after sufentanil injection were recorded. One minute after sufentanil injection, etomidate 0.3 mg/kg and cisatracurium 0.15 mg/kg were given for general anesthesia induction irrespective of the presence or absence of cough. The mean arterial pressure (MAP) and heart rate (HR) at time points just before remifentanil pretreatment administration (T0), 3 minutes after administration (T1), 1 minute after intubation (T2), and 3 minutes after intubation (T3) were recorded. Results: The incidence of cough in patients in the R group and C group was 4.8% and 31%, respectively. Compared with group C, the incidence and severity of cough in group R was significantly lower (P <0.01). No significant differences were observed in MAP and HR at the time of general anesthesia induction between the two groups (P> 0.05). Conclusion: Pretreatment with a small dose of remifentanil effectively and safely reduced the incidence and severity of cough induced by sufentanil during anesthesia induction and can be used as an alternative treatment to inhibit coughing caused by sufentanil.

scholarly journals A small dose of remifentanil pretreatment suppresses sufentanil-induced cough during general anesthesia induction: a randomized, double-blind, placebo-controlled trial

2019 ◽  
Author(s):  
Wendong Lin ◽  
Jiehao Sun ◽  
Shuying Fu
Keyword(s):  
General Anesthesia ◽  
Small Dose ◽  
Elective Surgery ◽  
Controlled Trial ◽  
Inhibitory Effect ◽  
Control Group ◽  
Anesthesia Induction ◽  
Double Blind ◽  
Prospective Randomized Controlled Trial ◽  
Size Groups

Abstract Background: Intravenous use of sufentanil can elicit cough. This study aimed to evaluate the inhibitory effect of pre-injection of a mall dose of remifentanil on sufentanil-induced cough during the induction of general anesthesia. Methods: This prospective, randomized, controlled trial was conducted from January 10, 2019 to March 01, 2019. A total of 100 patients undergoing elective surgery under general anesthesia were enrolled, and at last 84 patients were included and randomly allocated into two equal size groups (n=42): Patients in the Remifentanil group (R group) received an intravenous infusion of remifentanil 0.3 µg/kg (diluted to 2 ml) 1 minute before sufentanil injection; patients in the Control group (C group) received 2 ml of normal saline (NS) at the same time point. Injections of patients in both groups were completed within 5 seconds. Then, sufentanil 0.5 µg/kg was injected within 5 seconds and the number of coughs that occurred within 1 minute after sufentanil injection were recorded. One minute after sufentanil injection, etomidate 0.3 mg/kg and cisatracurium 0.15 mg/kg were given for general anesthesia induction irrespective of the presence or absence of cough. The mean arterial pressure (MAP) and heart rate (HR) at time points just before remifentanil pretreatment administration (T0), 3 minutes after administration (T1), 1 minute after intubation (T2), and 3 minutes after intubation (T3) were recorded. Results: The incidence of cough in patients in the R group and C group was 4.8% and 31%, respectively. Compared with group C, the incidence and severity of cough in group R was significantly lower (P <0.01). No significant differences were observed in MAP and HR at the time of general anesthesia induction between the two groups (P> 0.05). Conclusion: Pretreatment with a small dose of remifentanil effectively and safely reduced the incidence and severity of cough induced by sufentanil during anesthesia induction and can be used as an alternative treatment to inhibit coughing caused by sufentanil.

scholarly journals A small dose of remifentanil pretreatment suppresses sufentanil-induced cough during general anesthesia induction: a randomized, double-blind, placebo-controlled trial

2019 ◽  
Author(s):  
Wendong Lin ◽  
Jiehao Sun ◽  
Shuying Fu
Keyword(s):  
General Anesthesia ◽  
Small Dose ◽  
Elective Surgery ◽  
Controlled Trial ◽  
Inhibitory Effect ◽  
Control Group ◽  
Anesthesia Induction ◽  
Double Blind ◽  
Prospective Randomized Controlled Trial ◽  
Size Groups

Abstract Background: Intravenous use of sufentanil can elicit cough. This study aimed to evaluate the inhibitory effect of pre-injection of a mall dose of remifentanil on sufentanil-induced cough during the induction of general anesthesia. Methods: This prospective, randomized, controlled trial was conducted from January 10, 2019 to March 01, 2019. A total of 100 patients undergoing elective surgery under general anesthesia were enrolled, and at last 84 patients were included and randomly allocated into two equal size groups (n=42): Patients in the Remifentanil group (R group) received an intravenous infusion of remifentanil 0.3 µg/kg (diluted to 2 ml) 1 minute before sufentanil injection; patients in the Control group (C group) received 2 ml of normal saline (NS) at the same time point. Injections of patients in both groups were completed within 5 seconds. Then, sufentanil 0.5 µg/kg was injected within 5 seconds and the number of coughs that occurred within 1 minute after sufentanil injection were recorded. One minute after sufentanil injection, etomidate 0.3 mg/kg and cisatracurium 0.15 mg/kg were given for general anesthesia induction irrespective of the presence or absence of cough. The mean arterial pressure (MAP) and heart rate (HR) at time points just before remifentanil pretreatment administration (T0), 3 minutes after administration (T1), 1 minute after intubation (T2), and 3 minutes after intubation (T3) were recorded. Results: The incidence of cough in patients in the R group and C group was 4.8% and 31%, respectively. Compared with group C, the incidence and severity of cough in group R was significantly lower (P <0.01). No significant differences were observed in MAP and HR at the time of general anesthesia induction between the two groups (P> 0.05). Conclusion: Pretreatment with a small dose of remifentanil effectively and safely reduced the incidence and severity of cough induced by sufentanil during anesthesia induction and can be used as an alternative treatment to inhibit coughing caused by sufentanil.

scholarly journals Comparison of the combination of propofol and etomidate versus propofol or etomidate alone for induction of general anesthesia: a double-blind, randomized controlled trial

2021 ◽  
Author(s):  
Yun Li ◽  
Wenze Lu ◽  
David Li ◽  
Jon Zhou ◽  
Richard Applegate ◽  
...  
Keyword(s):  
Heart Rate ◽  
Randomized Controlled Trial ◽  
General Anesthesia ◽  
Controlled Trial ◽  
Anesthesia Induction ◽  
Double Blind ◽  
Randomized Controlled ◽  
Hemodynamic Variables ◽  
Processed Eeg ◽  
Induction Agents

IntroductionHemodynamic fluctuation during the induction of general anesthesia is a common event and adversely affect patients’ outcomes. The aim of this study is to investigate the impacts of different anesthesia induction agents: propofol, etomidate, and propofol-etomidate combination on patient hemodynamics and processed electroencephalography (EEG).Material and methodsSeventy-five patients undergoing elective non-cardiac surgery were randomly assigned to three groups of anesthesia induction agents: the group P received 2 mg/kg propofol, the group E received 0.3 mg/kg etomidate, and the group PE received the combination of 1mg/kg propofol plus 0.15mg/kg etomidate. Hemodynamic variables and processed EEG were measured during induction.ResultsHeart rate (HR) was significantly increased at intubation and 1 min after intubation compared with baseline in all three groups. Mean arterial pressure (MAP) decreased significantly after induction, at 5, and 10 min after intubation in group P (79.1±12.6, 77.0±14.2, 76.6±11.4 versus 93.2±9.9 mmHg; all P＜0.001). MAP increased significantly at intubation and 1 min after intubation in group E (104.7±13.0, 103.8±12.8 versus 92.9±10.2; P＜0.001, P=0.001 respectively). The incidence of myoclonus was lower in groups PE (4.0%) and P (4.0%) compared with that in group E (24.0%) (P=0.033). The incidence of pain at injection was higher in group P (28.0%) than that in groups PE and E (4.0% and 0.0%) (P=0.025).ConclusionsThe combination of propofol and etomidate used during induction of anesthesia provided a more stable BP profile, less pain at site of injection, and decreased myoclonic movements compared with propofol or etomidate alone.

scholarly journals Comparison of a small dose of oxycodone and sufentanil for the prevention of sufentanil-induced cough during general anesthesia induction: a prospective randomized controlled trial

2021 ◽  
Author(s):  
Lingli Shi ◽  
Yong He ◽  
Huanhuan Ni
Keyword(s):  
Randomized Controlled Trial ◽  
General Anesthesia ◽  
Small Dose ◽  
Elective Surgery ◽  
Controlled Trial ◽  
Anesthesia Induction ◽  
Clinical Trial Registry ◽  
Randomized Controlled ◽  
Prospective Randomized Controlled Trial ◽  
Hemodynamic State

Abstract Background: Sufentanil is widely used during anesthesia induction. However, sufentanil injections can cause cough through different mechanisms. This study aimed to evaluate the effectiveness of a small dose of oxycodone and sufentanil in suppressing sufentanil-induced cough (SIC) during general anesthesia induction.Methods: This prospective, randomized, controlled trial was conducted form February 12, 2019 to December 30, 2019. A total of 174 patients were scheduled for elective surgery, and 144 screened patients were randomly divided into 3 groups (n=48). Five minutes before sufentanil bolus (0.4 μg/kg), patients in group O received 0.02 mg/kg oxycodone intravenously within 5 s, those in group S received 0.02 μg/kg sufentanil within 5 s and those in group N received an equal volume of 0.9% normal saline within 5 s. Sufentanil was diluted to 5 μg/ml and administered within 5 s after pretreatment. The incidence and severity of cough in the three groups were evaluated within 1 minute after sufentanil injection during anesthesia induction. Mean arterial pressure (MAP) and heart rate (HR) were recorded at T0 (after entering the operation), T1 (3 minutes after pretreatment), T2 (before intubation), and T3 (1 minute after intubation).Results: The incidences of cough in group N, group O, and group S were 20 (41.6%), 7 (14.5%), and 6 (12.5%), respectively. Compared with group N, group O and group S exhibited significantly reduced incidence and severity of cough, and the severity of cough in group O and group S was dramatically reduced compared with that in group N (P<0.05). No significant differences in the rangeability of MAP and HR were noted at the four time points in the three groups (P> 0.05).Conclusion: Intravenous oxycodone (0.02 mg/kg) and sufentanil (0.02 μg/kg) represent effective approaches to reducing SIC in anesthesia induction and ensuring a relatively stable hemodynamic state during general anesthesia induction.Trial registration: Chinese Clinical Trial Registry (ChiCTR1900021087, registered date: January 28, 2019), http://www.chictr.org.cn

scholarly journals Effects of Small-Dose S-Ketamine On Anesthesia-Induced Atelectasis In Patients Undergoing General Anesthesia Accessed By Lung Ultrasound: Study Protocol For A Randomized, Double-Blinded Controlled Trial

2021 ◽  
Author(s):  
Di Zhang ◽  
Yi Liang ◽  
Di Bao ◽  
Wei Xiong ◽  
Lu Li ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Small Dose ◽  
Lung Ultrasound ◽  
Controlled Trial ◽  
Pulmonary Complications ◽  
Smooth Muscle Relaxation ◽  
Anesthesia Induction ◽  
Double Blind Study ◽  
Arterial Blood ◽  
Ultrasound Study

Abstract Background: Aelectasis after anesthesia induction in most patients undergoing general anesthesia may lead to postoperative pulmonary complications (PPCs) and affect postoperative outcomes. However, there is still no existing effective method used for the prevention of perioperative atelectasis. S-ketamine may prevent atelectasis due to airway smooth muscle relaxation and anti-inflammatory effects. Lung ultrasound is a portable and reliable bedside imaging technology for diagnosing anesthesia-induced atelectasis. In this study, we aim to assess whether a small dose of S-ketamine can reduce the incidence of atelectasis after intubation under general anesthesia using lung ultrasound, in order to prevent the early formation of perioperative atelectasis and PPCs.Methods: This is a single-institution, prospective, randomized controlled, parallel grouping, and double-blind study. From October 2020 to March 2022, 100 patients (18-60 years old) scheduled for elective surgery will be recruited from Beijing Tiantan Hospital, Capital Medical University, and randomly assigned to the S-ketamine group (Group S) and the normal saline group (Group N) at a ratio of 1:1. The label-masked agents will be administered 5 min before induction, and all patients will undergo a standardized general anesthesia protocol. Related data will be collected at three-time points: after radial artery puncture (T1), 15 min after tracheal intubation (T2), and before extubation (T3). The primary outcome will be the total lung ultrasound scores (LUS) at T2. Secondary outcomes will include LUS in six chest regions at T2, total LUS at T3, arterial blood-gas analysis results (PaCO2, PaO2) and PaO2/FiO2 at T2 and T3, plateau pressure(Pplat) and dynamic lung compliance (Cdyn) at T2 and T3. The incidence of postoperative complications associated with S-ketamine and PPCs at 2 h and 24 h after surgery will be recorded.Discussion: This trial aims to explore whether a simple and feasible application of S-ketamine before the induction of general anesthesia can prevent atelectasis. The results of this study may provide new ideas and direct clinical evidence for the prevention and treatment of perioperative pulmonary complications during anesthesia.Trial registration: ClinicalTrials.gov identifier: NCT04745286.

scholarly journals Lidocaine combined with magnesium sulfate preserved hemodynamic stability during general anesthesia without prolonging neuromuscular blockade: a randomized, double-blind, controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Waynice N Paula-Garcia ◽  
Gustavo H Oliveira-Paula ◽  
Hans Donald de Boer ◽  
Luis Vicente Garcia
Keyword(s):  
General Anesthesia ◽  
Magnesium Sulfate ◽  
Neuromuscular Blockade ◽  
Elective Surgery ◽  
Controlled Trial ◽  
University Hospital ◽  
Anesthesia Induction ◽  
Hemodynamic Parameters ◽  
Hemodynamic Stability ◽  
Double Blind

Abstract Background Lidocaine and magnesium sulfate have become increasingly utilized in general anesthesia. The present study evaluated the effects of these drugs, isolated or combined, on hemodynamic parameters as well as on the cisatracurium-induced neuromuscular blockade (NMB). Methods At a university hospital, 64 patients, ASA physical status I and II, undergoing elective surgery with similar pain stimuli were randomly assigned to four groups. Patients received a bolus of lidocaine and magnesium sulfate before the tracheal intubation and a continuous infusion during the operation as follows: 3 mg.kg− 1 and 3 mg.kg− 1.h− 1 (lidocaine - L group), 40 mg.kg− 1 and 20 mg.kg− 1.h− 1 (magnesium - M group), equal doses of both drugs (magnesium plus lidocaine - ML group), and an equivalent volume of isotonic solution (control - C group). Hemodynamic parameters and neuromuscular blockade features were continuously monitored until spontaneous recovery of the train of four (TOF) ratio (TOFR > 0.9). Results The magnesium sulfate significantly prolonged all NMB recovery features, without changing the speed of onset of cisatracurium. The addition of lidocaine to Magnesium Sulfate did not influence the cisatracurium neuromuscular blockade. A similar finding was observed when this drug was used alone, with a significantly smaller fluctuation of mean arterial pressure (MAP) and heart rate (HR) measures during anesthesia induction and maintenance. Interestingly, the percentage of patients who achieved a TOFR of 90% without reaching T1–95% was higher in the M and ML groups. Than in the C and L groups. There were no adverse events reported in this study. Conclusion Intravenous lidocaine plays a significant role in the hemodynamic stability of patients under general anesthesia without exerting any additional impact on the NMB, even combined with magnesium sulfate. Aside from prolonging all NMB recovery characteristics without altering the onset speed, magnesium sulfate enhances the TOF recovery rate without T1 recovery. Our findings may aid clinical decisions involving the use of these drugs by encouraging their association in multimodal anesthesia or other therapeutic purposes. Trial registration NCT02483611 (registration date: 06-29-2015).

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