The effect of pre‐emptive use of minimal dose fentanyl on fentanyl‐induced coughing

• Published in: Anaesthesia Vol. 65; no. 1; pp. 4 - 7
• Main Authors: Hung, K.‐C., Chen, C.‐W., Lin, V. C.‐H., Weng, H.‐C., Hsieh, S.‐W.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01-01-2010; Wiley-Blackwell
• Subjects: Adolescent; Adult; Aged; Anesthesia; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Anesthesiology; Anesthetics, Intravenous - administration & dosage; Anesthetics, Intravenous - adverse effects; Biological and medical sciences; Blood Pressure - drug effects; Clinical outcomes; Clinical trials; Cough - chemically induced; Cough - prevention & control; Dose-Response Relationship, Drug; Double-Blind Method; Drug Administration Schedule; Drug dosages; Drug therapy; Female; Fentanyl - administration & dosage; Fentanyl - adverse effects; Heart Rate - drug effects; Humans; Injections, Intravenous; Intraoperative Complications - chemically induced; Intraoperative Complications - prevention & control; Male; Medical sciences; Middle Aged; Side effects; Young Adult; Agonist; μ Opioid receptor; Fentanyl; Opiates; Anesthesia; Phenylpiperidine derivatives; Narcotic analgesic; Cough
• ISSN: 0003-2409; 1365-2044
• DOI: 10.1111/j.1365-2044.2009.06109.x

Summary
We performed a randomised, double‐blind study to evaluate the effect of the pre‐emptive use of minimal dose intravenous fentanyl (25 μg) on the incidence of cough caused by a larger bolus of intravenous fentanyl. Six hundred patients were randomly assigned to one of three groups to receive either 0.5 ml saline 0.9% 1 min before administration of fentanyl 150 μg (3 ml), or pre‐emptive fentanyl 25 μg (0.5 ml) 1 min before administration of fentanyl 125 μg or 150 μg. The incidence of fentanyl‐induced cough was significantly lower in both pre‐emptive groups (7 (3.5%) for 125 μg fentanyl and 15 (7.5%) for 150 μg fentanyl) than in the saline group (37 (18.5%); p = 0.001). We conclude that pre‐emptive use of fentanyl 25 μg, administered 1 min before bolus injection of fentanyl (125 or 150 μg), can effectively suppress fentanyl‐induced cough.