The use of nalmefene in remifentanil induced pediatric general anesthesia

Objective To evaluate the effect of nalmefene on remifentanil-induced cough during the induction of pediatric general anesthesia. Methods One hundred patients aged 2-6 years, classified as ASA Ⅰor Ⅱ, underwent elective high ligation of inguinal hernia sac under general anesthesia. They were randomly divided into 2 groups (n=50): nalmefene group (group N) and saline group(group C). Patients in group N received 0.25 μg/kg nalmefene intravenously 2 min before anesthesia induction, and patients in group C received the equal volume of normal saline 2 min before anesthesia induction. The incidence and severity of cough 1 min after the injection of remifentanil in two groups were recorded. The vital signs of two groups were monitored before the nalmefene injection (T0), before remifentanil injection (T1), 1 min after remifentanil injection (T2), at laryngeal mask airway insertion (T3), the time of skin incision(T4) and the end of surgery (T5). The postoperative pain scale and adverse reactions were also evaluated. Results The incidence of remifentanil-induced cough was 4% in group N and 36% in group C (P 0.05). No obvious adverse reaction was found in the two groups. Conclusions Nalmefene(0.25 μg/kg) injected before anesthesia induction can effectively prevent remifentanil-induced cough in pediatric patients. Key words: Nalmefene; Remifentanil; Pediatric; Cough