India: A study published in Respirology has investigated dextromethorphan as a potential cough suppressant used before flexible bronchoscopy. Dextromethorphan premedication may have an additive effect on cough suppression, according to researchers from the Department of Pulmonary Medicine & Critical Care, All India Institute of Medical Sciences, Bhubaneswar.
Flexible bronchoscopy is a diagnostic procedure used for visualisation of airways and lungs. Despite sedation and topical anaesthetics, cough is encountered invariably and remains a persistent challenge.
There needs to be more research and data related to ideal cough suppressants which could be used during flexible bronchoscopy.
Considering the above background, researchers in the present study determined the role of dextromethorphan premedication in relieving the cough during flexible bronchoscopy. They did a single-centre study including patients aged ≥18 years.
These patients received dextromethorphan syrup 30 ml (90 mg) or an equal volume of placebo one h before the procedure.
A visual analogue scale was used for rating cough severity and discomfort at the end of the procedure. Bronchoscopists also rated cough severity.
The study results are:
A total of 112 patients were screened.
Ninety-four patients with a mean age of 51 were randomized to either the dextromethorphan or placebo groups.
Both groups had 47 patients each.
The patients-rated median cough scores were 15 mm in dextromethorphan versus 20 mm in placebo groups reported at the end of the procedure.
There were similarities in Patients-rated median cough scores at one h, discomfort scores and midazolam and lignocaine usage between the two groups.
The bronchoscopist-rated median cough score was lower in the intervention than in the placebo groups.
Concluding further, they wrote one hour before flexible bronchoscopy, Dextromethorphan premedication has an additive effect on cough suppression under conscious sedation and topical lignocaine.
“Further trials are needed to reiterate our findings with certainty”, they mentioned.
Further reading:
Dextromethorphan premedication alleviates cough during flexible bronchoscopy in adults: A randomized, double-blind placebo-controlled trial.
https://onlinelibrary.wiley.com/doi/10.1111/resp.14445