Parameter measurement
coughing, cough, agitation, coughs, coughing reaction
The primary outcome measure was the incidence of induced coughing due to endotracheal extubation. The definition of induced cough was patients with coughing induced by extubation during recovery from anaesthesia. Secondary outcome measures were the incidence of agitation and active extubation, endotracheal tube tolerance ranking and cardiovascular reactions prior to extubation and postoperative cough and postoperative pharyngeal pain. The degree of endotracheal tube tolerance was scored as follows: 0 = no response during breathing, including spontaneous and mechanical ventilation conditions; 1 = no response during breathing, including spontaneous and mechanical ventilation conditions, but slight action response to aspiration of sputum (inconspicuous coughing reaction); 2 = tolerance to mechanical ventilation, but moderate action response to aspiration of sputum (single coughing); 3 = tolerance to ventilation, severe coughing reaction (multiple coughs that lasted shorter than 5 s) caused by sputum aspiration; 4 = could not tolerate mechanical ventilation, severe coughing reaction caused by sputum aspiration; and 5 = extubation behaviour. Coughing was scored as follows: 0 = no cough; 1 = mild cough; 2 = moderate cough, multiple coughs that lasted shorter than 5 s; and 3 = severe cough, multiple coughs that lasted longer than 5 s. The definition of agitation was patient showed thrashing or violent behaviour with removal of tubes and tracheal tube during recovery from anaesthesia according to previous report [