Median effective dose of intravenous nalmefene for preventing sufentanil-induced cough in children aged 1–6 years: a prospective randomized controlled trial - Report - MDSpire
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Determining the Median Effective Dose of Intravenous Nalmefene for the Prevention of Sufentanil-Induced Cough in Pediatric Patients Aged 1 to 6: A Prospective Randomized Controlled Study
Clinical Report: Median Effective Dose of Nalmefene for Pediatric SIC
Overview
This study establishes the median effective dose (ED50) of intravenous nalmefene for preventing sufentanil-induced cough (SIC) in children aged 1 to 6 years. The ED50 was found to be 0.064 μg/kg.
Background
Sufentanil-induced cough is a significant concern during anesthetic induction in pediatric patients due to their limited functional residual capacity and increased oxygen demand. This study addresses the lack of established prophylactic dosing for nalmefene in this vulnerable population.
Data Highlights
Group
SIC Incidence
Group A (Normal Saline)
45.9%
Group B (0.025 μg/kg)
38.1%
Group C (0.05 μg/kg)
30.2%
Group D (0.1 μg/kg)
11.3%
Key Findings
The incidence of SIC decreased with increasing doses of nalmefene.
Group D (0.1 μg/kg) showed a significant reduction in severe cough compared to Group A (normal saline).
The ED50 for nalmefene was determined to be 0.064 μg/kg.
No significant differences in hemodynamic parameters or postoperative FLACC scores were observed across groups.
The estimated ED95 was 0.242 μg/kg, requiring extrapolation beyond the observed dose range.
Clinical Implications
The established ED50 of 0.064 μg/kg for nalmefene provides a reference point for clinicians to prevent SIC in young children undergoing anesthesia.
Conclusion
Intravenous nalmefene effectively reduces SIC in pediatric patients, with an ED50 identified.
