Perbandingan Angka Kejadian Batuk Pascabronkoskopi pada Kelompok Premedikasi Kombinasi Kodein 10 mg dan Klorfeniramin Maleat 4 mg dengan Premedikasi Tunggal Kodein 10 mg

Maulidar Saputra, Ardi Zulfariansyah, Budiana Rismawan


Bronkoskopi merupakan tindakan esensial dalam penegakan diagnosis maupun terapetik pada saluran pernapasan. Beberapa penelitian menunjukkan kejadian batuk yang tinggi baik selama tindakan maupun setelah bronkoskopi. Saat ini belum ada konsensus tentang pemberian premedikasi yang optimal mengurangi kejadian batuk pada pasien yang menjalani bronkoskopi. Tujuan penelitian ini adalah mengetahui perbedaan efektivitas pemberian premedikasi kodein dengan kombinasi kodein-klorfeniramin maleat (CTM) dalam mengurangi batuk setelah bronkoskopi. Penelitian ini merupakan penelitian eksperimental yang dilakukan secara prospektif terhadap 52 subjek penelitian yang menjalani bronkoskopi di Rumah Sakit Paru Rotinsulu pada bulan Desember 2017Februari 2018. Pada penelitian ini data numerik diuji dengan uji t tidak berpasangan, untuk data kategorik diuji dengan uji chi-square. Hasil penelitian ini didapatkan angka kejadian batuk pascabronkoskopi pada kelompok pasien yang diberikan premedikasi dengan kombinasi kodein 10 mg dan CTM 4 mg lebih rendah dibanding dengan kelompok yang diberikan premedikasi tunggal dengan kodein 10 mg pada semua pengukuran dengan perbedaan bermakna (p<0,05). Simpulan penelitian ini adalah pemberian premedikasi dengan kombinasi kodein 10 mg dan CTM 4 mg lebih efektif menurunkan kejadian batuk pascabronkoskopi dibanding dengan premedikasi tunggal Kodein 10 mg.

Kata kunci: Batuk pascabronkoskopi, premedikasi kodein, premedikasi kodein-CTM


Comparison of Postbronchoscopic Cough Incidence betweeb Patients Premedicated with 10 mg Codeine  and 4 mg Chlorpheniramine Maleate Combination and premedicated with 10 mg Codeine Only

Bronchoscopy is an essential airway procedure for diagnostic and therapeutic purposes that could cause discomfort and complications. Some studies have shown that cough complaint is often made during and after the procedure. There is no consensus that explains how to optimally premedicate a patient to reduce cough. The objective of this study was to understand the difference in the effectiveness of codeine and codeine and chlorpheniramine maleat (CTM) combination as a premedication to prevent coughing after bronchoscopy. This was a double blind, prospective experimental study in Rotinsulu Pulmonary Hospital from December 2017 to February 2018. Fifty two patients who were undergoing bronchoscopy under general anesthesia were randomly allocated to codeine group (n=26) and  Codeine-CTM Group (n=26). It was showed that the incidence of cough after bronchoscopy in the group using combination of 10 mg Codeine and 4 mg CTM premedication was lower than in the group with 10 mg Codeine premedication in all measurements. Therefore, premedication using 10 mg codeine and 4 mg CTM combination is more effective to reduce the incidence of cough after bronchoscopy when compared to the single premedication with codeine 10 mg.

Key words: Postbronchoscopic cough, premedication with codeine, premedication with codeine-CTM


Batuk pascabronkoskopi, premedikasi kodein, premedikasi kodein-CTM

Full Text:



Manthous C, Tobin MJ. Flexible bronchoscopy (airway endoscopy). Am J Respir Crit Care Med. 2015;191:1–8.

Rand IA Du, Barber PV, Goldring J, Lewis RA, Mandal F, Munavvar M, dkk. British Thoracic Society guideline for advanced diagnostic and therapeutic flexible bronchoscopy in adults. Thorax. 2011;66(Suppl 3):1–21.

Chadha M, Kulsreshtha M, Biyani A. Anaesthesia for bronchoscopy. Indian J Annesth. 2015;59(9):567–73.

Narula M, McGovern AE, Yang SK, Farrel MJ, Mazzone SB. Afferent neural pathways mediating cough in animals and humans. J Thorac Dis. 2014;6(Suppl 7):S712–9.

Jung SY, Park HB. Kim J. The effect of subhypnotic dose of propofol for prevention of coughing in adult during emergence from anesthesia with sevoflurane and ramifentanil. Korean J Anesthesiol. 2014;66(2):120–6.

Polverino M, Polverino F, Fasolino M, Ando F, Alfieri A, Blasio FD. Anatomy and neuro-patophysiology of the cough reflex arc. Multydisc Resp Med. 2012;7(1):1–5

Padma L. Current drugs for the treatment of dry cough. Assoc Physicians India. 2013;61(Suppl):9–13.

Ling IT, Piccolo F, Mulrennan SA, Phillips MJ. Posture influences patient cough rate, sedative requirement, and comfort during bronchoscopy: an observational cohort study. Cough. 2011;7(9):1–7.

Wang H, Nugent WC. Cough-induced bilateral spontaneous pneumothorax. Ann Thorac Surg. 2010:90(4):1363–5.

Kain ZN. Preoperative evaluation, premedication, and induction of anesthesia in infants and children. Am Soc Anesthesiol Ann Meet. 2011;214:1–10.

Mutolo D, Canning BJ. Central and peripheral control of cough in: abstract book of international symposium on pain and cough. Italy: University of Florence; 2015.

Amaya F, Izumi Y, Matsuda M, Sasaki M. Tissue injury and related mediators of pain exacerbation. Curr Neuropharmacol 2013;11(6):592–7.

Vora A, Nadkar MY. Codeine: a relook at the old antitussive. Assoc Physicians India. 2015;63(4):80–5.

Sheen MJ, Chang FL, Ho ST. Anesthetic premedication: new horison of an old practice. Acta Anesthesiol Taiwanica. 2014;52(3):134–42.

Benly P. Role of histamine in acute inflammation. J Pharm Sci Res. 2015;7(6): 373–6.

Hattori M, Yamazaki M, Ohashi W, Tanaka S, Hattori K, Todoroki K, dkk. Critical role of endogenous histamine in promoting end-organ tissue injury in sepsis. Intens Care Med Experiment. 2016;4(36):1–19.

Church DS, Church MK. Pharmacology of antihistamines. WAO J. 2011;4(Suppl 3):22–7.

European Medicine Agency-Pharmacovigilance Risk Assessment Committee (PRAC). 2015. Codeine containing medicinal products for the treatment of cough and/or cold in paediatric patients. United Kingdom: Europ Med Agency. 2015.

Dicpinigaitis PV, Morice AH, Birring AH, McGarvey L, Smith JA, Canning BJ, dkk. Antitussive drugs—past, present, and future. Pharmacol Rev. 2014:66(2);468–512.

Bosler DC. Older-generation antihistamines and cough due to upper airway cough syndrome (UACS): Efficacy and Mechanism. Lung . 2008;186(Suppl 1):74–7.



  • There are currently no refbacks.

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.


This Journal indexed by


Creative Commons License
MKB is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License


View My Stats