Korean J Anesthesiol.  2012 Jun;62(6):512-517. 10.4097/kjae.2012.62.6.512.

Sufentanil infusion before extubation suppresses coughing on emergence without delaying extubation time and reduces postoperative analgesic requirement without increasing nausea and vomiting after desflurane anesthesia

• Lee JY
• Lim BG
• Park HY
• Kim NS

• KMID: 1828024
• DOI: http://doi.org/10.4097/kjae.2012.62.6.512

Abstract

BACKGROUND
Coughing, hypertension, tachycardia, and even laryngospasm can occur due to airway irritation during emergence from anesthesia. We investigated the effect of maintaining a sufentanil infusion during emergence from anesthesia by evaluating the incidence of cough and recovery profiles at extubation.
METHODS
In total, eighty-four patients undergoing an elective laparoscopic hysterectomy were randomly divided into two sufentanil groups and a control group. During emergence, sufentanil was administered in the sufentanil groups at a rate of 0.2 microg/kg/hr (Group S1) or 0.3 microg/kg/hr (Group S2), and saline was administered to the control group. Cough score, hemodynamic changes, and recovery profiles, such as duration from skin closure to a bispectral index of 80, to eye opening at verbal command, to tracheal extubation and the total duration of study solution infusion, were recorded. The pain score, the total volume of administered patient-controlled analgesia (PCA), and the postoperative nausea and vomiting (PONV) score were evaluated 1, 6, and 24 hours after surgery.
RESULTS
Groups S1 and S2 showed significantly lower cough scores and smaller hemodynamic changes on extubation compared to Group C. Recovery profiles showed no significant differences among the three groups. Pain score, PONV at 1 hour postoperatively, and the total volume of PCA administered at all evaluation times were significantly lower in Groups S1 and S2 than in the control group. However, pain score, and PONV at 6 hours and 24 hours postoperatively showed no significant differences.
CONCLUSIONS
A sufentanil infusion (0.2-0.3 microg/kg/hr) during emergence from desflurane anesthesia may suppress coughing on extubation in patients with body mass indexes (BMI) of 21-26 without delaying extubation time. It may also reduce the postoperative analgesic requirement without increasing PONV.

Keyword

Anesthesia recovery period; Cough; Sufentanil

MeSH Terms

Airway Extubation
Analgesia, Patient-Controlled
Anesthesia
Anesthesia Recovery Period
Body Mass Index
Cough
Eye
Hemodynamics
Humans
Hypertension
Hysterectomy
Incidence
Isoflurane
Laryngismus
Nausea
Passive Cutaneous Anaphylaxis
Postoperative Nausea and Vomiting
Skin
Sufentanil
Tachycardia
Vomiting
Isoflurane
Sufentanil