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.