Application via mechanical dropper alleviates sufentanil-induced cough: a prospective, randomized, single-blinded trial.

BACKGROUND: It was reported that prolonging the injection time or diluting administration can reduce the incidence of opioid-induced cough. However, the incidence of sufentanil-induced cough (SIC) via a standardized infusion rate is unclear. A mechanical dropper is an infusion filtering device commonly used for intravenous degassing; it can also be used to administer special drugs due to its temporary storage and dilution effect. This study assesses the effectiveness of administration via mechanical dropper on SIC.

METHODS: Two hundred patients undergoing general anesthesia were enrolled. Patients received sufentanil at a strength of 0.3 μg·kg- 1 either via T-connector (group C) or by mechanical dropper (group M) at 1 ml·s- 1 . Cough severity was graded as none (0), mild (1-2), moderate (3-5), or severe (> 5), and the incidence of SIC was evaluated for 5 min after the start of sufentanil injection. Other adverse reactions such as hypotension, hypertension, bradycardia, tachycardia, hypoxemia, vomiting, and aspiration during the induction period of general anesthesia were also observed. The primary outcome was the incidence of SIC. The secondary outcomes were the severity of SIC and other adverse reactions.

RESULTS: The incidence of SIC in group M was significantly lower than that in group C (2% versus 21%, P = 0.000), and the prevalence of moderately severe coughing was also statistically different (none in group M versus 11% in group C, P = 0.001). However, there were no statistical differences in the incidence of other adverse reactions between two groups (P > 0.05).

CONCLUSION: Sufentanil application via mechanical dropper can significantly alleviate the occurrence of SIC during the induction phase of total intravenous general anesthesia. This method is simple, safe, and reliable, and has wide prospective application for clinical use.

TRIAL REGISTRATION: Chinese Clinical Trial Register, ChiCTR-IOR-17011561 . Registered on 3 June 2017.