Effect of dexmedetomidine-propofol on the response of cough by equipotent boluses of fentanyl and sufentanil

Objective To investigate the effect of dexmedetomidine(DEX)-propofol in suppressing the response of cough by equipotent boluses of fentanyl and sufentanil.Methods A total of 200 patients of ASA Ⅰ or Ⅱ,aged 18 y-65 y undergoing elective surgery were randomized into four groups of 50 each,using computer-generated random numbers.Group C1 or Group C2:normal saline 0.15 ml/kg+intralipid 0.1 ml/kg,group DP1 or group DP2:DEX 0.6 μg/kg+propofol 1 mg/kg.1 min after receiving drugs mentioned before,patients in group C1 or group DP1 received iv.fentanyl (4 μg/kg) and patients in group C2 or group DP2 received iv sufentanil (0.5 μg/kg).After fentanyl administration,the onset time and the severity of cough for 1 min were recorded.Severity of coughing was graded as mild (1-2),moderate (3-5) and severe (＞5) based on the number of coughs.Induction of general anesthesia was continued with sufficient propofol and vecuronium 0.12 mg/kg,then tracheal intubation was performed by a practiced anesthesiologist.BP and HR were recorded before infusion (T0),before intubation (T1) and after intubation (T2).Results The incidence of coughing was higher in group C1 (20/50,40％) or group C2 (12/50,24％) than in group DP1 (0/50,P＜0.01) or group DP2 (0/50,P＜0.01).However,no difference in the severity of cough between group C1 and group C2 (P＞0.05).Conclusions With group C1-2,SBP and DBP of group DP1-2 was significantly increased in T1,[(94±13) mm Hg(1 mm Hg=0.133 kPa) and (92±14) mm Hg vs (114±13) mm Hg and (116±15) mm Hg; (56±9) mm Hg and (55±10) mm Hg vs (70±10) mm Hg and (72±10) mm Hg] (P＜0.01); but HR decreased significantly in T1-2 [(62±11) bpm and (65±10) bpm or (61±8) bpm and (65±9) bpm vs (68±11) bpm and (80± 15) bpm or (71 ± 18) bpm and (84± 17) bpm] (P＜0.01),Compared with T1,SBP and DBP of group C1-2 increased significantly in T2[(122±22) mm Hg vs (94±13) mm Hg and (117±20) mm Hg vs (92±14) mm Hg; (76±16) mm Hg vs (56±9) mm Hg and (76±14) mm Hg vs (55±10) mm Hg](P＜0.01).Conclusions Pretreatment DEX-propofol could completely suppress the response of cough by equipotent boluses of fentanyl and sufentanil,and the hemodynamics during general anesthesia induction and tracheal intubation were more stabler. Key words: Dexmedetomidine;  Propofol;  Fentanyl;  Sufentanil;  Cough