Efficacy of Propofol vs Placebo in the Prevention of Coughing During Emergence of General Anesthesia Under Desflurane
Status:
Completed
Trial end date:
2017-12-01
Target enrollment:
Participant gender:
Summary
Emergence of general anesthesia is a critical period, in the same way as the induction of
anesthesia, during which several adverse events may occur. Extubation may even be more
difficult than the intubation, with a higher respiratory complications rate. Among these,
cough is common and expected. It can be associated with significant complications including
hypertension, tachycardia, increased intracranial pressure, bleeding at the surgical site or
even wound dehiscence.
The incidence of coughing during emergence of general anesthesia varies depending on the type
of airway instrumentation, the population under study, agents used for the maintenance of the
anesthesia and techniques used to prevent coughing. In the literature, the incidence of
coughing during emergence of general anesthesia under endotracheal intubation varies from 38
to 96%. In our center, the incidence of coughing during emergence of general anesthesia under
desflurane and endotracheal intubation is 30 % according to a local preliminary study.
Propofol is well-known to inhibit airway reflexes. Total intravenous anesthesia (TIVA) is
associated with a lower incidence of coughing compared to inhalated anesthesia. The efficacy
of propofol at a subhypnotic dose to reduce coughing during emergence has recently been
demonstrated in patients undergoing nasal surgery under sevoflurane. However, the most
effective antitussive dose remains unknown and its efficacy during anesthesia under
desflurane has not yet been demonstrated.
Propofol is rapidly available, simple to administer and has an interesting pharmacological
profile, among others due to its short half-life.
The aim of this study is to evaluate if an intravenous bolus of 0.5 mg/kg of propofol is more
effective than placebo administration to decrease the incidence of coughing during emergence
of general anesthesia under desflurane (PROPOREV). Propofol could also reduce the incidence
of postoperative nausea and vomiting (PONV).