The effect of lidocaine on remifentanil-induced cough.

Abstract

This study was performed to investigate the incidence of remifentanil-induced cough and evaluate the efficacy of lidocaine on its prevention. Five-hundred patients, aged 18-70 years, were randomly allocated into two groups to receive either lidocaine 0.5 mg x kg(-1) or 0.9% normal saline intravenously 1 min before remifentanil administration at a target effect-site concentration of 4 ng x ml(-1). Any episode of cough was classified as coughing and graded as mild (1-2), moderate (3-4) or severe (5 or more). We found that the overall incidence of cough was significantly higher in the saline group (69 patients; 27.6%) than that in the lidocaine group (38 patients; 15.2%) (p < 0.001). The results of logistic regression indicated that age and smoking were associated with remifentanil-induced cough. This study demonstrated that intravenously administered lidocaine 0.5 mg x kg(-1) effectively suppresses remifentanil-induced cough without possible systemic lidocaine toxicity.