Intravenous dexamethasone pretreatment reduces remifentanil induced cough

BACKGROUND Remifentanil infusion is commonly used for general anesthesia but reflex cough can occur after an intravenous (IV) infusion. This study was designed to examine the effect of IV-dexamethasone on remifentanil-induced cough (RIC). METHODS One hundred thirty patients scheduled for elective surgery were randomly assigned into two groups that received by either 2 ml of IV 0.9% saline (Group C, n = 68) or 10 mg of dexamethasone (Group D, n = 62) 5 min before administration of remifentanil at a target effect-site concentration of 5 ng/ml. The incidence and severity of coughs of each patient were recorded. RESULTS The overall incidence of cough was 6.5% (4/62 patients) in Group D and 26.5% (18/68 patients) in the Group C (P = 0.002). The severity of cough observed was significantly different by dexamethasone pretreatment (P = 0.02) but there were no significant hemodynamic changes. CONCLUSIONS Pretreatment with dexamethasone after IV administration was effective in suppressing the reflex cough induced by remifentanil infusion.