Korean J Anesthesiol.  2011 Oct;61(4):292-296. 10.4097/kjae.2011.61.4.292.

The clinical effective dose of alfentanil for suppressing cough during emergence from desflurane anesthesia

• Lee MG
• Chang YJ
• Park JM
• Park HY

• KMID: 1766769
• DOI: http://doi.org/10.4097/kjae.2011.61.4.292

Abstract

BACKGROUND
The administration of short-acting opioids before emergence is useful for preventing emergence cough induced by an endotracheal tube. This study examined the clinically effective dose of alfentanil for suppressing cough during emergence from desflurane anesthesia.
METHODS
Twenty-nine adult patients undergoing elective oral surgery were enrolled in this study. During emergence from anesthesia, the patients received alfentanil diluted in 10 ml normal saline when the end-tidal vol% of desflurane decreased to 3%. The initial alfentanil dose was 16 microg/kg. The alfentanil dose for consecutive patients, determined by Dixon's up-and-down method, increased or decreased by 2 microg/kg according to a previous patient's result.
RESULTS
The 50% effective dose (ED50) of alfentanil for suppressing cough during emergence from desflurane anaesthesia was 9.3 +/- 1.5 microg/kg according to Dixon's up-and-down method. Isotonic regression revealed an ED50 and ED95 (95% confidence interval) of alfentanil 10.0 microg/kg (6.8-13.2 microg/kg) and 14.0 microg/kg (7.7-19.4 microg/kg), respectively.
CONCLUSIONS
The ED95 of alfentanil for suppressing emergence cough was 14.0 microg/kg. A single bolus administration of alfentanil during emergence from anesthesia was useful for suppressing emergence cough.

Keyword

Alfentanil; Dixon's up-and-down method; Emergence cough

MeSH Terms

Adult
Alfentanil
Analgesics, Opioid
Anesthesia
Cough
Humans
Isoflurane
Surgery, Oral
Alfentanil
Analgesics, Opioid
Isoflurane