Dezocine prevents sufentanil-induced respiratory depression during awake intubation: a multicenter, randomized, controlled study

Abstract BackgroundSufentanil has sedative and inhibitory effects on the intubation response, but high doses of sufentanil can cause coughing and respiratory depression. Dezocine has been documented effectively suppressing sufentanil-induced cough. Whether dezocine can inhibit the respiratory depression caused by sufentanil is unknown. This study aims to observe the efficacy of dezocine combined with sufentanil in awake intubation.MethodsFour hundred and three patients of American Society of Anesthesiologists physical status Classes I and II, aged 18–65 years, were randomly allocated into four groups: Group saline (saline + 0.4 ug/kg sufentanil), Group D0.05 (dezocine 0.05 mg/kg + 0.4 ug/kg sufentanil), Group D0.10 (dezocine 0.10 mg/kg + 0.4 ug/kg sufentanil), and Group D0.15 (dezocine 0.15 mg/kg + 0.4 ug/kg sufentanil). The primary outcome of our study was to observe the incidence of respiratory depression. Secondary outcomes included the success rate of intubation, ease of intubation, intubation comfort score, sore throat, hoarseness, lethargy, limb movement, glottis exposing and the satisfaction of patients during intubation. Hemodynamic changes were recorded after sufentanil injection and awake intubation.ResultsThere was no difference in the effect of normal saline and 0.05 mg/kg dezocine on respiratory depression (P = 0.603). The incidence of respiratory depression in Group D0.10 and Group D0.15 was lower than that of Group saline. Cough was statistically different between the four groups (P < 0.05). The incidence of cough in the dezocine groups was lower than that of Group saline. There was a significant difference in patient intubation satisfaction between the four groups (P < 0.05). The satisfaction of patients during intubation were significantly higher in the dezocine groups. Sore throat, hoarseness, lethargy and success rate of intubation were similar between the four groups (all P > 0.05).ConclusionsOur study indicated that 0.10 mg/kg and 0.15 mg/kg dezocine might prevent the occurrence of cough and respiratory depression induced by sufentanil during awake intubation and improve patient satisfaction.Trial registrationClinicaltrials.gov (NCT02673723), 2- 4- 2016.