Effect of esketamine on the EC50 of remifentanil for suppression of choking cough during extubation.
iScience May 16, 2025 Shouyi Chen, Liurong Lin, Qian Zhou et al. 2 citations
Choking cough during emergence from anesthesia is common (15%-94%) and can cause severe discomfort, especially after neck surgery. Combining esketamine with remifentanil reduces the median effective concentration (EC50) of remifentanil needed to suppress cough during extubation in male patients undergoing anterior cervical spine surgery. The EC50 was 1.88 ng/mL with esketamine versus 2.55 ng/mL with remifentanil alone. No significant differences occurred in intraoperative hemodynamics or extubation time. Lower postoperative pain scores were observed at 2 and 24 hours. The combination effectively lowers the required remifentanil dose and reduces early pain, offering a reference for perioperative care.