Intravenous Dexamethasone Pretreatment Reduces Fentanyl-induced Cough

Lin, Jui-An; Chen, Fa Chang; Lee, Meei Shyuan; Horng, Huei Chi; Cherng, Chen‐Hwan; Yeh, Chun Chang; Wong, Chih Shung

doi:10.1016/s0929-6646(08)60022-4

Cited by 26 publications

(22 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Many factors have been associated with fentanyl-induced cough, such as drug dosage and concentration, order of drug administration, intravenous injection rate and site [8], individual physical condition, age, sex, weight, disease history, smoking, and family genetics. A number of techniques have been applied to reduce the incidence of fentanylinduced cough, including the use of betamethasone (8.3 vs. 35%), dexamethasone (6.3 vs. 21.3%) [9], ephedrine (21 vs. 65%) [10], lidocaine (13.1%) [11], ketamine (7.2 vs. 21.6%) [12], and propofol (6.7%) [13], a change the order of administering the drugs, the speed of fentanyl administration, and fentanyl concentration. The use of the drugs in these earlier studies was unable to completely prevent fentanyl-induced cough, and some of them are very limited in terms of their clinical application.…”

Section: Discussionmentioning

confidence: 99%

Effect of intravenous dezocine on fentanyl-induced cough during general anesthesia induction: a double-blinded, prospective, randomized, controlled trial

et al. 2011

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Effect of intravenous dezocine on fentanyl-induced cough during general anesthesia induction: a double-blinded, prospective, randomized, controlled trial

et al. 2011

View full text Add to dashboard Cite

show abstract

“…Effectively reducing fentanyl-induced cough response from 28% to 6% after aerosol inhalation of salbutamol (a selective β 2 -adrenergic bronchodilator) further supports the mechanism that fentanyl induces cough via its bronchoconstriction effect (5). In addition, opioid-induced histamine release (14) and muscle rigidity leading to sudden adduction of the vocal cords or supraglottic obstruction (15) are plausible explanations.…”

Section: Discussionmentioning

confidence: 99%

Effects of different priming doses of propofol on fentanyl-induced cough during anesthesia induction: A preliminary randomized controlled study

Tang

Qian

Zhang

et al. 2009

Upsala Journal of Medical Sciences

View full text Add to dashboard Cite

Fentanyl-induced cough is not an uncommon condition during the induction of general anesthesia. A preliminary randomized controlled study was designed to observe the effects of different priming doses of propofol on fentanyl-induced cough during anesthesia induction. A total of 120 patients were randomized into 4 groups (n = 30) to receive the intravenous injection of intralipid (group I), propofol 1 mg·kg-1 (group II), propofol 1.5 mg·kg-1 (group III), or propofol 2 mg·kg-1 (group IV) 1 minute before a bolus of fentanyl 2.5 µg·kg-1. The occurrence and severity of cough were recorded for 2 minutes after fentanyl bolus. The severity of cough was graded as none (grade 0), mild (grade 1–2), moderate (grade 3–4), or severe (grade 5 or more). The average bolus time of fentanyl was 1.5 ± 0.3 seconds in the present study. The incidence of fentanyl-induced cough was 80.0% in group I, 40.0% in group II, 6.7% in group III, and 3.3% in group IV, respectively. Groups II, III, and IV had a lower incidence and less severity of cough than group I (P < 0.05). Groups III and IV had a lower incidence and less severity of cough than group II (P < 0.05). In summary, a priming dose of more than 1 mg·kg-1 of propofol is effective to suppress fentanyl-induced cough in a dose-dependent manner. We suggest using a priming dose of propofol 1.5 mg·kg-1 to suppress cough during the anesthesia induction with propofol and fentanyl in clinical practice.

show abstract

“…In a cohort study of 1311 adult patients, these authors reported that increasing age, cigarette smoking, prior epidural injection of lidocaine or a priming dose of vecuronium were associated with a decreased risk of fentanyl-induced cough (4, 15, 18). Lin et al found that only light smoking, not heavy smoking could decrease the frequency of fentanyl-induced cough, but the association between age and incidence of cough was not observed in their study (7, 11, 19). In Tang and his colleagues' study, the incidence of cough was 80%.…”

Section: Discussionmentioning

confidence: 69%

“…Former reports have demonstrated that a fentanyl-induced cough can be reduced with pretreatment of certain drugs (4-9). Strategies to decrease the occurrence of a reflex cough following an intravenous bolus of fentanyl include techniques to prolong injection time or the use of terbutaline, clonidine, dexamethasone and lidocaine (1, 4, 7, 8, 10, 11) however, these approaches are not uniformly effective. All of these medications have bronchorelaxant effects on the airway's smooth muscle (4, 5, 12).…”

Section: Introductionmentioning

confidence: 99%

Propofol is Effective to Depress Fentanyl-Induced Cough during Induction of Anesthesia

Sedighinejad¹,

Nabi²,

Haghighi³

et al. 2013

Anesth Pain

View full text Add to dashboard Cite

BackgroundVarious attempts have been made to reduce the incidence of fentanyl-induced cough during anesthesia induction. We hypothesized that an appropriate dose of propofol might suppress fentanyl-induced cough.ObjectivesA study had been designed to observe the effects of propofol on a fentanyl-induced cough during anesthesia induction.Patients and MethodsWe performed a randomized, double-blind study to evaluate the effect of the pre-emptive use of minimal dose intravenous propofol (20 mg) on the incidence of cough caused by a larger bolus of intravenous fentanyl. Group 1 patients were given fentanyl at a dosage of 4 µg/kg. Group 2 received 4µg/kg fentanyl and 20 mg propofol. The two groups were evaluated in 0, 5 and 10 second intervals following the injection of fentanyl.ResultsMean age, weight, and, height was 35 ± 10.45, 67.99 ± 10.92, and 165.33 ± 31.84 respectively. The incidence of fentanyl induced cough was 29 (74.4%) in placebo group compared with 10 (25.6%) in the propofol group. There was a significant difference in the incidence and severity of cough between group 1 and 2 (P < 0.0001). This study also showed that propofol could decrease cough incidence in patients who smoke.ConclusionsPriming dose of propofol (20mg) one minute prior to fentanyl injection was effective in suppressing a fentanyl-induced cough.

show abstract

Intravenous Dexamethasone Pretreatment Reduces Fentanyl-induced Cough

Abstract: DEX (10 mg, IV) 5 minutes prior to fentanyl injection reduces the incidence of FIC and can be an ideal premedicant for general anesthesia induction.

Cited by 26 publications

References 23 publications

Effect of intravenous dezocine on fentanyl-induced cough during general anesthesia induction: a double-blinded, prospective, randomized, controlled trial

Effect of intravenous dezocine on fentanyl-induced cough during general anesthesia induction: a double-blinded, prospective, randomized, controlled trial

Effects of different priming doses of propofol on fentanyl-induced cough during anesthesia induction: A preliminary randomized controlled study

Propofol is Effective to Depress Fentanyl-Induced Cough during Induction of Anesthesia

Contact Info

Product

Resources

About