Cough
Conditions
Keywords
extubation
Brief summary
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.
Interventions
DRUGRemifentanil
Receive remifentanil bolus and infusion guided by an algorithm.
DRUGNormal saline
Receive normal saline bolus and infusion guided by the remifentanil algorithm.
Sponsors
University of Vermont Medical Center
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
Yes
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
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of cough | Measured from surgical end time to patient transfer out of room, approximetly 30 minutes and up to 45 minutes | Notes presence of cough during emergence |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Coughing grade | Measured from surgical end time to patient transfer out of room, approximetly 30 minutes | Ranks severity of cough during emergence: cough was graded according to the following scoring guidelines: 0=no cough, 1=slight cough, cough without obvious contraction of the abdomen, 2=moderate cough, strong and sudden contraction of the abdomen lasting for less than 5 seconds and 3=severe cough, strong and sudden contraction of the abdomen sustained for more than 5 seconds. |
| Extubation time | Measured from termination of the anesthetic to extubation, approximetly 5 minutes and up to 30 minutes | Time between the termination of the anesthetic and extubation |
| Time to recovery | Measured from extubation to purposeful movement, approximetly 5 minutes and up to 30 minutes | Time between extubation and the ability to perform purposeful movement |
Contacts
Primary ContactElie Sarraf, MD.CM.
Backup ContactAlex F Friend
Outcome results
None listed