As per this study, the occurrence of sufentanil-induced cough was 31.1% within 1 minute, as following previous studies. Ketorolac tromethamine 0.5 mg/kg IV pretreatment 5 minutes’ prior anaesthesia usage can be safe and significantly reduce the incidence of coughing reactions during the initiation in general anaesthesia patients for a relaxed medical experience with care.

This prospective randomized controlled study focused on investigating the consequence of pretreatment using ketorolac tromethamine (KT) on sufentanil-induced cough in patients given general anaesthesia.

Out of 102 patients screened, 90 patients were booked for elective surgery under general anaesthesia. These patients were grouped as; KT group or observation group and; C group or Control group. The KT group was given KT 0.5 mg/kg intravenously (IV) within 3 seconds, whereas the control group was given the same quantity of normal saline IV; all 5 minutes prior to the anaesthesia initiation. A sufentanil bolus 0.5 μg/kg (within 3 seconds) IV was administered in all patients. A minute after, propofol 2.5 mg/kg and vecuronium 0.15 mg/kg IV was used, and endotracheal intubation was directed by laryngoscopy. Within a minute after sufentanil injection, the numbers of coughs were noted down. 

Heart rate (HR), mean arterial pressure (MAP), and pulse oxygen saturation (SpO2) were recorded at different time points i.e. T0 (immediately before pretreatment), T1 (5 minutes following pretreatment), T2 (before intubation), T3 (1 minute following intubation) and T4 (5 minutes following intubation). The occurrence of adverse reactions was investigated.

As compared to the controls, the occurrence and severity of cough in the KT group were considerably lower within a minute after sufentanil IV. No significant differences in MAP, HR and SpO2 between the 2 groups at above mentioned time points were found (figure 1):

Figure 1: Assessment of MAP, HR and SpO2 at various time intervals

Between both the groups, no substantial difference in sufentanil, propofol, remifentanil and vecuronium doses; nausea and vomiting occurrence; the delay of recovery; dizziness; drowsiness or respiratory depression were witnessed. But, the occurrence of restlessness and total of patients with VAS scores more than 3 in the KT group were considerably lesser as compared to C group.

Pretreatment with KT intravenously can significantly decrease the occurrence of sufentanil-induced cough throughout the initiation of general anaesthesia. It can also considerably ease the after surgery incision pain and restlessness in the phase of recovery.