Publication: Preemptive use of Small Dose Fentanyl Suppresses Fentanyl Induced Cough
Date
2012
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
ABSTRACT
Background
Fentanyl, a synthetic opioid, is a popular choice amongst anaesthesiologists in
the operating room. Pre induction intravenous fentanyl bolus is associated with
coughing in 28 – 65% of patients. Fentanyl induced cough is not always benign and
can be remarkably troublesome at the most critical moment of anaesthesia when
airway reflex is lost.
Objectives
To study the effect of pre emptive use of minimal dose fentanyl through the
peripheral venous cannulae on the incidence of cough by a larger bolus of
intravenous fentanyl.
Methods
One hundred and fifty patients aged 18 -75 years undergoing elective surgical
procedures were randomized into three groups of 50 each. The first group received
0.5 ml saline 0.9 % intravenously one minute prior to the administration of fentanyl
150μg (3 ml); the second group received pre emptive fentanyl 25μg(0.5ml) prior
to the administration of fentanyl 125μg(2.5ml); and the third group received
preemptive fentanyl 25 μg(0.5ml), followed by the administration of fentanyl
150μg(3ml).. Based on the number of coughs observed, cough severity was graded
as mild(1-2), moderate (3-5),or severe (>5).
Results
The incidence of fentanyl induced cough was significantly lower in both pre
emptive group 4(8%) for 125μg fentanyl and 7(14%) for 150μg than in the saline
group 15(30%).
Conclusion
Pre- emptive use of minimal dose fentanyl 25μg administered one minute before a
larger bolus dose of fentanyl (125 or 150μg ) can effectively suppress cough.
KEY WORDS
Cough, fentanyl, pre emptive
Description
Shrestha SK, Bhattarai B, Shah RS
Department of Anesthesia Kathmandu University School of Medical Science Dhulikhel Hospital, Kathmandu University Hospital Dhulikhel Kavre, Nepal