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""This study evaluated the effect of limiting maximal infusion-pump flow rate on suppression of remifentanil-induced cough during target-controlled infusion. Two hundred and ten patients were randomly assigned to receive remifentanil at an effect-site concentration of 4.0?ng.ml?1 with maximal flow rate limited to 100 (group R100), 200 (group R200), or 1200?ml.h?1 (group R1200). The number of episodes of cough were recorded and graded as mild (1�C2), moderate (3�C4), http://www.selleck.cn/products/AP24534.html or severe (5 or more). The incidence of cough was 2.9% in group R100, 5.7% in group R200 and 25.7% in group R1200. Patients in group R100 and R200 had a significantly lower incidence of cough than those in group R1200 (p? http://www.selleckchem.com/products/jq1.html maximal infusion rate during remifentanil TCI suppressed remifentanil-induced cough. Remifentanil, an opioid used as an analgesic and antitussive agent, sometimes causes cough during induction of anaesthesia, as with other opioids of the fentanyl series [1�C4]. The incidence of cough after intravenous administration of remifentanil varies between 25% and 34% [1�C3]. Although opioid-induced cough is usually benign and self-limiting, it may disrupt the smooth induction of anaesthesia and can cause harm in predisposed patients through an increase of intracranial, intra-ocular, or intra-abdominal pressure or unstable haemodynamics. Pretreatment with drugs known to reduce airway reactivity, such as lidocaine or propofol, could reduce the incidence http://www.selleckchem.com/products/Rapamycin.html of remifentanil-induced cough, as for fentanyl-induced cough [1, 5, 6]. However, these pharmacological interventions do not appear to have achieved complete avoidance of cough, and the intervention itself can cause problems [7]. Our previous study [1] demonstrated that the incidence of cough increases when plasma remifentanil concentration is high and effect-site concentration is low. This study was designed to investigate whether limiting the infusion pump��s maximal flow rate could effectively suppress remifentanil-induced cough during target-controlled infusion (TCI). This study was approved by our institutional review board (Ajou University Hospital, Suwon, Korea), and written informed consent was obtained from all patients. A total of 210 patients, of ASA physical status 1�C2 and aged 18�C70?years, undergoing general anaesthesia, were enrolled in the study. Exclusion criteria included a history of bronchial asthma or chronic obstructive pulmonary disease, respiratory tract infection, or hypertension treated with angiotensin converting enzyme inhibitors. Patients who smoked were included in the study. No premedication was administered before surgery. A 20-G cannula was inserted into the forearm or dorsum of the hand and connected to a three-way stopcock before arrival in the operating theatre.