Median effective dose of intravenous nalmefene for preventing sufentanil-induced cough in children aged 1–6 years: a prospective randomized controlled trial - Scorecard - 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 Scorecard: 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
At a Glance
Category
Detail
Condition
Sufentanil-Induced Cough (SIC)
Key Mechanisms
Nalmefene is a selective μ-opioid receptor antagonist that prevents SIC by occupying μ-opioid receptors on airway vagal afferent C-fiber terminals.
Target Population
Children aged 1–6 years undergoing elective laparoscopic surgery
Care Setting
Pediatric anesthesia
Key Highlights
ED50 of nalmefene for preventing SIC was determined to be 0.064 μg/kg.
SIC incidence decreased dose-dependently across treatment groups.
Severe cough was eliminated in the highest nalmefene dose group (0.1 μg/kg).
No significant differences in hemodynamic parameters or postoperative pain scores were observed.
Guideline-Based Recommendations
Diagnosis
SIC should be monitored in pediatric patients receiving sufentanil.
Management
Nalmefene can be administered prior to sufentanil to prevent SIC.
Monitoring & Follow-up
Postoperative pain and hemodynamic stability should be assessed.
Risks
Potential for airway obstruction and rapid hemoglobin desaturation due to coughing.
Patient & Prescribing Data
Pediatric patients aged 1–6 years undergoing elective laparoscopic procedures.
Nalmefene at 0.1 μg/kg effectively prevents SIC without compromising hemodynamic stability.
Clinical Best Practices
Administer nalmefene 1 minute before sufentanil to optimize SIC prevention.
Monitor for hemodynamic stability and postoperative pain following nalmefene administration.
