The Efficacy and Safety of Butamirate Citrate as Pre-Medication to Alleviate Post-Bronchoscopy Cough: A Double-Blind Randomized Placebo-Controlled Trial
Keywords:
butamirate citrate, post-bronchoscopy cough, fiberoptic bronchoscopyAbstract
Background and Objectives: Post-bronchoscopy cough is a common complication after fiberoptic bronchoscopy procedure despite the use of several medications and technique to suppress it. This study aimed to evaluate the efficacy and safety of butamirate citrate, a centrally acting antitussive, in alleviating post-bronchoscopy cough.
Methods: Patients scheduled for fiberoptic bronchoscopy under total intravenous anesthesia with controlled ventilation using laryngeal mask airway were randomized to receive butamirate citrate 2 hours prior to the procedure or a similar looking placebo tablet. Severity of cough was evaluated by the outcome assessor using a modified cough severity score at the 1st, 6th and 12th hour post-bronchoscopy and the patient’s discomfort using visual analogue score(VAS) which was determined by the participants. The heart rate, blood pressure and oxygen saturation were also assessed.
Results: A total of 84 patients scheduled for fiberoptic bronchoscopy under total intravenous anesthesia with controlled ventilation using laryngeal mask airway were randomly allocated in a double-blind, parallel-group trial. Forty-two patients received butamirate citrate 2 hours prior to the procedure and the other 34 patients received a similar looking placebo tablet. Eight participants were withdrawn from the study. Based on the intention-to-treat analysis, median cough severity score was significantly lower in the butamirate group at the 1st (p= 0.0291) and 12th hour (p=0.0366) post- bronchoscopy. Higher proportion of patients in butamirate citrate group had no cough and it was statistically significant at the 12th hour (p=0.032). Patient’s discomfort based on VAS, median change in systolic blood pressure and mean change heart rate were not significantly different from the two groups. Oxygen saturations of all patients were normal. One patient had nausea and another presented with urticaria in the butamirate group but not significantly different with placebo.
Conclusion: Butamirate citrate is efficacious and safe as a premedication in alleviating post-bronchoscopy cough in patient undergoing FOB under total intravenous anesthesia with controlled ventilation using laryngeal mask airway based on the modified cough severity score but it does not affect patient’s discomfort, heart rate and blood pressure.
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