Dose‐dependent attenuation by fentanyl on cough during emergence from general anesthesia

Yoo, Young Chul; Na, Sungwon; Jeong, Jong Ju; Choi, Eun Mi; Moon, B.-E.; Lee, Jeong Rim

doi:10.1111/j.1399-6576.2011.02529.x

Cited by 22 publications

(11 citation statements)

References 21 publications

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“…These drugs can be useful when administered in combination with opioids as part of a multimodal therapeutic strategy to reduce the need for opioid, which may be controversial in patients undergoing thoracic surgery due to their possible respiratory depressant effect,[411] influence on cough mechanism[12] and PONV in the post-operative period. [13] Our study confirms the analgesic effect of clonidine after thoracic surgery as described by other authors in different types of surgeries in various age groups.…”

Section: Discussionmentioning

confidence: 99%

The effect on post-operative pain of intravenous clonidine given before induction of anaesthesia

Samantaray¹,

Rao²,

Chandra³

2012

Indian J Anaesth

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Background:Treatment of acute post-thoracotomy pain is particularly important not only to keep the patient comfortable but also to minimize pulmonary complications.Aim:This study was designed to test the effect of pre-induction administration of clonidine, given as a single intravenous dose, on post-operative pain scores and fentanyl consumption in patients after thoracic surgery.Setting and Design:Tertiary referral centre. Prospective, randomised, double-blind, placebo-controlled trial.Methods:Sixty patients were randomly allocated to receive clonidine (3 mcg/kg) or saline pre-operatively before induction of anaesthesia. The primary endpoint was pain on coughing (visual analogue scale (VAS) 0–100 mm) 120 min after surgery, time to first analgesic injection in the post-anaesthesia care unit (PACU) and 24-h fentanyl consumption.Statistical Analysis:For between-group comparisons, t-test and U-test were used as appropriate after checking normality of distribution. The incidence of complications between the groups was compared by Fisher's exact test.Results:The post-operative VAS for the first 120 min and the fentanyl consumption at 24 h was significantly greater in the placebo group compared with the clonidine group (P<0.05). The sedation score was increased in the clonidine group during study drug infusion, but did not differ significantly on admission to the PACU.Conclusions:A single intravenous dose of clonidine (3 mcg/kg) given before induction of anaesthesia significantly reduced the post-operative VAS score in the initial period and fentanyl consumption during 24 h after thoracic surgery.

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Section: Discussionmentioning

confidence: 99%

The effect on post-operative pain of intravenous clonidine given before induction of anaesthesia

Samantaray¹,

Rao²,

Chandra³

2012

Indian J Anaesth

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“…One of the common and useful side-effects of opioid analgesics is suppression of the cough reflex, which is the basis of their use in oral cough suppressants (3). Sufentanil, fentanyl, and remifentanil infusion before recovery from general anesthesia have previously been reported to suppress coughing during extubation (9,21,22). Opioids may inhibit the cough reflex by a direct effect on the cough center in the medulla, at doses lower than those required for analgesia (3).…”

Section: Discussionmentioning

confidence: 99%

A small dose of remifentanil pretreatment suppresses sufentanil-induced cough during general anesthesia induction: a randomized, double-blind, placebo-controlled trial

Lin

Sun

Fu³

2019

Preprint

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Background: Intravenous use of sufentanil can elicit cough. This study aimed to evaluate the inhibitory effect of pre-injection of a mall dose of remifentanil on sufentanil-induced cough during the induction of general anesthesia. Methods: This prospective, randomized, controlled trial was conducted from January 10, 2019 to March 01, 2019. A total of 100 patients undergoing elective surgery under general anesthesia were enrolled, and at last 84 patients were included and randomly allocated into two equal size groups (n=42): Patients in the Remifentanil group (R group) received an intravenous infusion of remifentanil 0.3 µg/kg (diluted to 2 ml) 1 minute before sufentanil injection; patients in the Control group (C group) received 2 ml of normal saline (NS) at the same time point. Injections of patients in both groups were completed within 5 seconds. Then, sufentanil 0.5 µg/kg was injected within 5 seconds and the number of coughs that occurred within 1 minute after sufentanil injection were recorded. One minute after sufentanil injection, etomidate 0.3 mg/kg and cisatracurium 0.15 mg/kg were given for general anesthesia induction irrespective of the presence or absence of cough. The mean arterial pressure (MAP) and heart rate (HR) at time points just before remifentanil pretreatment administration (T0), 3 minutes after administration (T1), 1 minute after intubation (T2), and 3 minutes after intubation (T3) were recorded. Results: The incidence of cough in patients in the R group and C group was 4.8% and 31%, respectively. Compared with group C, the incidence and severity of cough in group R was significantly lower (P <0.01). No significant differences were observed in MAP and HR at the time of general anesthesia induction between the two groups (P> 0.05). Conclusion: Pretreatment with a small dose of remifentanil effectively and safely reduced the incidence and severity of cough induced by sufentanil during anesthesia induction and can be used as an alternative treatment to inhibit coughing caused by sufentanil.

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“…It is important that anesthesiology services implement ''cough-free extubation'' protocols in order to decrease the production of aerosols and respiratory drops. For this purpose, there are some useful strategies such as extubation with the deep patient in spontaneous ventilation and the use of some medications such as lidocaine [2], dexmedetomidine [3], remifentanil [4], and fentanyl [5] just before extubation. Furthermore, it is desirable to have the orotracheal tube clamped before being removed from the patient.…”

Section: Alexander Trujillomentioning

confidence: 99%

Response to Wen and Li, Anesthesia Procedure of Emergency Operation for Patients with Suspected or Confirmed COVID-19 (DOI: 10.1089/sur.2020.040)

Trujillo

2020

Surgical Infections

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Dose‐dependent attenuation by fentanyl on cough during emergence from general anesthesia

Abstract: Fentanyl suppressed cough in a dose-related manner during recovery from general sevoflurane anesthesia, and 2 mcg/kg may be considered as a proper dose.

Cited by 22 publications

References 21 publications

The effect on post-operative pain of intravenous clonidine given before induction of anaesthesia

The effect on post-operative pain of intravenous clonidine given before induction of anaesthesia

A small dose of remifentanil pretreatment suppresses sufentanil-induced cough during general anesthesia induction: a randomized, double-blind, placebo-controlled trial

Response to Wen and Li, Anesthesia Procedure of Emergency Operation for Patients with Suspected or Confirmed COVID-19 (DOI: 10.1089/sur.2020.040)

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