Comparison of cough induced by equivalent doses of fentanyl,sufentanil,and remifentanil

Objective To compare the incidence and severity of cough induced by equivalent doses of fentanyl,sufentanil,and remifentanil. Methods A total of 315 patients with ASA Ⅰor Ⅱ were randomized into 3 groups (n=105) to receive equivalent doses of fentanyl (2 ug/kg,fentanyl group),sufentanil (0.2 ug/kg,sufentanil group),or remifentanil (2 ug/kg,remifentanil group) via IV push within 5 seconds,respectively. The incidence and severity of cough,pulse oxygen saturation (SpO2),and systolic blood pressure (SBP),heart rate (HR) in patients with cough were observed for 2 minutes after drug administration.Results Remifentanil group had a higher incidence of cough (54.3%) than fentanyl (33.3%,P0.01) and sufentanil groups (30.5%,P0.01). The cough was severer in remifentanil group than those in fentanyl and sufentanil groups (P0.01). SBP increased from (128±12) to (139±16) mm Hg,and HR from (74±10) to (87±16) beats/min in patients with cough (P0.01). Within 2 minutes after drug administration,59% of patients in remifentanil group experienced hypoxemia (SpO290%) necessitating manually assisted mask ventilation,while no patients experienced hypoxemia in fentanyl and sufentanil groups.Conclusion Remifentanil induces a higher incidence and more severity of cough than equivalent doses of fentanyl and sufentanil.