Effect on cough frequency and intensity during extubation of two plasma concentrations of remifentanil using TACAN: Randomised controlled clinical trial

Abstract Introduction Cough at the time of extubation may trigger anaesthesia-related adverse events. A technique that has been found to limit cough during this stage of the anaesthesia procedure is the use of remifentanil. Objective To compare cough frequency and intensity at the time of extubation with two different plasma concentrations of remifentanil, 3–4 ng/ml and 2–3 ng/ml, using target controlled anaesthesia. Materials and methods Randomised controlled clinical trial carried out at the Institute for Blind and Deaf Children in Valle del Cauca, in patients taken to elective ear surgery. Patients were randomly assigned to one of two groups. The first group (T) received an infusion of remifentanil at a plasma concentration of 3–4 ng/ml ( n  = 50). The second group (U) received an infusion of remifentanil at a plasma concentration of 2–3 ng/ml ( n  = 51). Data were analysed using the Student t test and the non-parametric Mann Whitney U test; the Chi square test was used for determining associations. Results Cough intensity and frequency were less in group T compared to group U (OR: 3.73; 95% CI: 1.3–10.7), and there was no difference between the two groups regarding emergence from anaesthesia. Conclusions The presence of at least one cough episode during extubation is less with plasma concentrations of remifentanil of 3–4 ng/ml than 2–3 ng/ml.