Does Precise Delivery of Remifentanil Decrease Coughing at Emergence From Anesthesia

University of Vermont Medical Center

Status and phase: Unknown; Phase 4

Conditions: Cough

Treatments: Drug: Normal saline; Drug: Remifentanil

Study type: Interventional

Funder types: Other

Identifiers

NCT03783676

18-0415

Details and patient eligibility

About

The investigators want to find a way to reduce or stop patients from coughing at the end of surgery when the breathing tube is taken out. The breathing tube is removed when the participants are waking up from anesthesia, and are at the point when the participants can breathe on your own. In most types of surgery, coughing at this point is common, and does not affect the participants very much, if at all. But for surgery involving the eye or the head and neck, coughing right after surgery can cause bleeding at the site of surgery.

This study will use a short-acting pain drug called remifentanil at the end of surgery to prevent coughing. The investigators will give the participants this medicine for 5 to 30 minutes. The point of the study is to test if using a simple computer program to guide precise delivery of how much of the drug is given to the participants is effective at reducing or preventing coughing.

Enrollment: 60 estimated patients

Sex: All

Ages: 18 to 80 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

1. Between the ages of 18 and 80

2. ASA of 1-3

3. Undergoing any of the following elective cases:

   1. thyroidectomy (partial or complete)
   2. parathyroidectomy
   3. ophthalmological surgery

4. Will require endotracheal intubation.

Exclusion criteria

1. Lean Body Mass < 20 kg,
2. BMI > 45
3. Presence of pulmonary dysfunction
4. Any history of anaphylaxis to remifentanil
5. Requiring the use of total intravenous anesthesia.
6. Per the discretion of the anesthesia provider

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Quadruple Blind

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60 participants in 2 patient groups, including a placebo group

Remifentanil group

Experimental group

Description:

Will receive remifentanil bolus and infusion guided by an algorithm

Treatment:

Drug: Remifentanil

Control group

Placebo Comparator group

Description:

Will receive normal saline bolus and infusion guided by the remifentanil algorithm

Treatment:

Drug: Normal saline