Comparison of the incidence and severity of cough after alfentanil and remifentanil injection

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Abstract

Background:

Intravenous administration of fentanyl derivatives can induce cough paradoxically. This study examined the incidence and severity of cough after a bolus of alfentanil and remifentanil.

Methods:

Four hundred and sixty-five patients, aged 18–70 years, were allocated randomly to three groups to receive alfentanil 10 μg/kg, remifentanil 1 μg/kg or an equal volume of 0.9% saline intravenously over 10 s. Any episode of cough was classified as coughing and graded as mild (1–2), moderate (3–4) or severe (5 or more).

Results:

The overall incidence of cough was higher in the opioid groups than in the saline group. The remifentanil group [39/150 patients; 26.0% (95% CI, 19.6–33.6%)] showed a higher incidence than the alfentanil group [11/152 patients; 7.2% (95% CI, 0.4–12.6%)] (P<0.001). There was no significant difference in the severity of cough between the alfentanil group and the remifentanil group.

Conclusion:

This study demonstrated that equipotent boluses of alfentanil and remifentanil induced coughing, even though the incidence of cough after alfentanil administration was lower than that after remifentanil administration.

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