Fentanyl Cough Reflex And Its Prevention And Treatment Of Clinical Research

The prophylactic efficacy ofⅳlidocaine, dexamethasone and vecuronium on fentanyl induced cough【Abstract】Objective To investigate the incidence of pre-induction coughing after iv bolus of 3ug/kg fentanyl, and evaluate the therapeutic efficacy and safety of preemptive lidocaine, dexamethasone and vecuronium on fentanyl induced cough. Methods 400 patients of ASAⅠandⅡfor elective operations, aged from 18 to 65 yrs old , were randomly allocated into five equal groups. The patients received saline (group 1), lidocaine 0.5mg/kg (group 2), lidocaine 1.0mg/kg (group 3), dexamethasone 5mg(group 4) or vecuronium 0.01mg/kg(group 5), respectively. After two (group 1, 2, 3) or five minutes(group 4, 5), 3ug/kg fentanyl was given. The occurrence of cough and vital signs were recorded. The cough was graded as mild(1-2times), moderate(3-4 times) or severe(5 or more times). Results 42.5% of patients in group 1 experienced, whereas the frequency was 31.3% in group 2, 22.5% in group 3, 21.3% in group 4 and 18.8% in group 5, respectively. There was no significant difference in the incidence of cough between the group 1 and group 2(p＞0.05). However significant difference was found between the group 1 and group 3, 4, 5. Severity of cough was significantly different in group 5 compared with the rest of groups. The cough emergence time was more shortly in group 5 than in other groups. There were more patients in group 3 experienced dizziness or tinnitus, although it was transient and self-limited. More patients were observed with diplopia in group 5 than other four groups. Conclusion Pretreatment with intravenous lidocaine, dexamethasone or vecuronium was effective and safe in preventing fentanyl induced cough. Repeated dosage of an intravenous bolus fentanyl can decrease the incidence of fentanyl-induced cough【Abstract】Objective To investigate the incidence of pre-induction coughing after a repeat dosage of 1ug/kg fentanyl. Methods 300 patients with ASAⅠorⅡfor elective procedures, aged 18 to 65 yrs old, received an iv bolus of 1ug/kg fentanyl via a peripheral cannula over two seconds prior to anesthesia induction. Then the patients who experienced cough were randomly allocated into two epual groups according to the interval of repeated injection:Group I(2 min group) received the same dosage of fentanyl after two minutes and group 2(5 min group) was given after 5 min. The occurrence of cough and vital signs were recorded. Cough was graded as mild(1-2times),, moderate(3-4 times) or severe(5 or more times). Results The incidence of 1ug/kg fentanyl-induced cough was 0% of patients in Group 1 and 40.7% patients in group 2 with cough after repeated dosage of fentanyl. There was significant difference in the incidence between the two groups(p＜0.05), but no significant difference in the severity between two groups. No severe side effects were observed in all patients. Conclusion The incidence of fentanyl-induced cough decreased significantly after repeated dosage of fentanyl, but relieved with the prolonging of the injection interval.