Abstract
Background
Intravenous administration of sufentanil during anesthesia induction induces cough (SIC), sometimes triggers a severe reaction. We wanted to investigate the inhibitory effect of low-dose esketamine on cough induced by sufentanil during the induction of general anesthesia, as well as its postoperative impact on mental status.
Methods
A total of 256 adult patients were randomly allocated to receive either esketamine (Group EK) or normal saline (Group C). One minute before the administration of sufentanil, Group EK and Group C were injected with esketamine (0.075 mg/kg, diluted with normal saline to 3 ml) and normal saline (3 ml), respectively. The primary outcomes were the incidence (the basis of the presence or absence of cough) and severity (the frequency of cough episodes) of cough within 2 minutes after sufentanil injection.The secondary outcomes included hemodynamic variables and mental status or postoperative events.
Results
A total of 236 adult patients were randomized into two groups (n = 236): Group EK (n = 118) and Group C (n = 118). The incidence of cough in Group EK (21.2%) was significantly lower than that in Group C (40.7%) (P < 0.05). The incidence rates for each grade were as follows: 9.3% and 16.9% for Grade 2, and 0% and 4.2% for Grade 3, respectively.The difference had statistical sense.The MAP and HR at T4 (during tracheal intubation) and T5 (1 minute post-intubation) were significantly lower in Group EK (P < 0.05). There was no significant difference in mental status, time to awareness, duration force recovery or satisfaction with anesthesia.
Conclusion
Pretreatment with low-dose esketamine can reduce the incidence and severity of cough induced by sufentanil and maintain hemodynamic stability during anesthesia induction without increasing mental status.
Trial registration
Chinese Clinical Trial Registry (ChiCTR2400084940, date of registration: 05/28/2024)