Assessment of the cough reflex after propofol anaesthesia for colonoscopy

Guglielminotti, Jean; Rackelboom, T.; Tesnière, Antoine; Panhard, X; Mentré, France; Bonay, Marcel; Mantz, Jean; Desmonts, Jean-Marie

doi:10.1093/bja/aei175

Cited by 20 publications

(8 citation statements)

References 27 publications

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“…According to several previous studies, the wake-up time for combined sedation with an opiate and a benzodiazepine is 35-60 min and discharge time 75-120 min after the procedure [30][31][32]. Alternatively, propofol might have a shorter or less potent effect on the cough reflex than the combination of midazolam and hydrocodone [33,34].…”

Section: Clinical Practice D Stolz Et Almentioning

confidence: 99%

Propofol versus combined sedation in flexible bronchoscopy: a randomised non-inferiority trial

Stolz¹,

Kurer²,

Meyer³

et al. 2009

European Respiratory Journal

109

115

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Combined sedation with a benzodiazepine and an opiate has been proposed as standard sedation for bronchoscopy. Propofol is a sedative-hypnotic with a rapid onset of action and fast recovery time, but carries the potential risk of respiratory failure.Consecutive patients (n5200) were randomly allocated to receive either the combination midazolam and hydrocodone or intravenous propofol. The primary end-points were the mean lowest arterial oxygen saturation during bronchoscopy and the readiness-for-discharge score 1 h after the procedure.The mean lowest arterial oxygen saturation during bronchoscopy did not differ across treatment groups (p50.422), and the number of patients recording an arterial oxygen saturation of f90% on at least one occasion was similar in both groups (p50.273). The median (interquartile range) readiness-for-discharge score 1 h after the procedure was significantly higher in the propofol group than in the combined sedation group (8 (6-9) versus 7 (5-9); p50.035). Patients assigned propofol exhibited less tachycardia during bronchoscopy and for o1 h after the examination. Minor procedural complications were noted in 71 (35.5%) patients and exhibited a similar incidence in both treatment arms (p50.460).Propofol is as effective and safe as combined sedation in patients undergoing flexible bronchoscopy, thus representing an appealing option if timely discharge is a priority.

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Section: Clinical Practice D Stolz Et Almentioning

confidence: 99%

Propofol versus combined sedation in flexible bronchoscopy: a randomised non-inferiority trial

Stolz¹,

Kurer²,

Meyer³

et al. 2009

European Respiratory Journal

109

115

View full text Add to dashboard Cite

show abstract

“…The sensitivity of cough reflex did not appear to be modified by estimated propofol concentrations as low as 1.2 μ g ml -1 . [5] This, in combination with the suppression of swallowing reflex and laryngeal closure reflexes at sedative doses of propofol in our patient with possible preexisting subclinical swallowing abnormalities, might have resulted in a violent coughing response to minimal, yet undetected pooled oropharyngeal secretions.…”

Section: Discussionmentioning

confidence: 83%

Propofol-induced violent coughing in a patient with Becker′s muscular dystrophy

Jain

2011

Indian J Pharmacol

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Propofol anesthesia is often associated with decreased incidence of gagging, coughing or laryngospasm, and provides intense suppression on airway reflex during tracheal intubation and laryngeal mask airway insertion. Propofol pretreatment is also effective in reducing the occurrence of opioid-induced coughing. These benefits are often attributed to bronchodilator and sedative effects of propofol. However, severe coughing following sedative doses of 1% propofol has not been reported so far. We report a rare case of violent coughing following low-dose propofol infusion in a patient with Becker's muscular dystrophy.

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“…Although several reports failed to demonstrate the effect of propofol on suppression of cough induced by artificial irritation [27,28], other investigations showed that propofol represses airway reflexes [29,30]. In addition, Hans et al [9] reported that residual concentration of propofol during emergence decreased the probability of coughing.…”

Section: Discussionmentioning

confidence: 99%

Does the type of anesthetic agent affect remifentanil effect-site concentration for preventing endotracheal tube-induced cough during anesthetic emergence? Comparison of propofol, sevoflurane, and desflurane

Lee

Choi

et al. 2014

Journal of Clinical Anesthesia

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Assessment of the cough reflex after propofol anaesthesia for colonoscopy

Abstract: This study indicates that residual sedation after propofol anaesthesia for colonoscopy does not adversely affect the cough reflex.

Cited by 20 publications

References 27 publications

Propofol versus combined sedation in flexible bronchoscopy: a randomised non-inferiority trial

Propofol versus combined sedation in flexible bronchoscopy: a randomised non-inferiority trial

Propofol-induced violent coughing in a patient with Becker′s muscular dystrophy

Does the type of anesthetic agent affect remifentanil effect-site concentration for preventing endotracheal tube-induced cough during anesthetic emergence? Comparison of propofol, sevoflurane, and desflurane

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