Prophylactic Intravenous Lidocaine at Different Doses for Fentanyl-Induced Cough (FIC): A Meta-Analysis

Tan, Wulin; Li, Si; Liu, Xiaochen; Gao, Xiang; Huang, Wenqi; Guo, Junying; Wang, Zhongxing

doi:10.1038/s41598-018-27457-3

Cited by 8 publications

(5 citation statements)

References 34 publications

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“…Another study found that 0.5 mg⋅kg −1 lidocaine had a significant effect and that increasing the concentration to 1.5 mg⋅kg −1 did not further reduce the incidence and severity of FIC ( Pandey et al, 2005 ). A recent meta-analysis also showed that both low (0.5–1 mg⋅kg −1 ) and high doses of lidocaine (1.5–2 mg⋅kg −1 ) were effective at reducing FIC incidence, there was no significant difference between low or high doses of lidocaine ( Tan et al, 2018 ). However, high doses of lidocaine may lead to arrhythmia and depression ( Schlimp and Wiedermann, 2005 ).…”

Section: Prevention and Treatment Of Fentanyl-induced Coughmentioning

confidence: 99%

Mechanism and Management of Fentanyl-Induced Cough

et al. 2020

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Fentanyl-induced cough (FIC) often occurs after intravenous bolus administration of fentanyl analogs during induction of general anesthesia and analgesia procedure. The cough is generally benign, but sometimes it causes undesirable side effects, including elevated intra-abdominal, intracranial or intraocular pressure. Therefore, understanding the related mechanisms and influencing factors are of great significance to prevent and treat the cough. This paper reviews the molecular mechanism, influencing factors and preventive administration of FIC, focusing on the efficacy and side effects of various drugs in inhibiting FIC to provide some medical reference for anesthesiologists.

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Section: Prevention and Treatment Of Fentanyl-induced Coughmentioning

confidence: 99%

Mechanism and Management of Fentanyl-Induced Cough

et al. 2020

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“…However, our study found the use of lidocaine was associated with a reduced risk of FIC owing to the arrhythmogenic effects of lidocaine. An appropriate dose of lidocaine can reduce the risk of FIC [ 37 ], and the prophylactic effect of intravenous lidocaine on the risk of opioid-induced cough has already demonstrated [ 38 , 39 ]. Fourth, the use of vecuronium can affect histamine release, which is involved in the onset of FIC [ 40 ].…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Fentanyl-Induced Cough Following General Anesthesia in Adults: A Retrospective Study from a Single Center in China

Zhao

Wang

et al. 2021

Med Sci Monit

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Background Fentanyl-induced cough (FIC) during general anesthesia induction and postoperative nausea and vomiting are common complications, yet the risk factors for FIC remain controversial. This retrospective study was conducted at a single center in China and aimed to investigate the risk factors for fentanyl-induced cough following general anesthesia in adults. Material/Methods A total of 601 adult patients undergoing elective surgery were enrolled, and the incidence of FIC during general anesthesia induction and postoperative adverse events were recorded. The risk factors for FIC during general anesthesia induction and postoperative nausea and vomiting were assessed using multivariate logistic regression analysis. Results The incidence of FIC, nausea, and vomiting were 21.8%, 6.3%, and 4.5%, respectively. The results of multivariate logistic regression analysis indicated that pharyngitis history was associated with an increased risk of FIC during general anesthesia induction (odds ratio [OR]: 2.852; 95% confidence interval [CI]: 1.698–4.792; P <0.001), whereas use of lidocaine could protect against FIC risk (OR: 0.649; 95% CI: 0.557–0.757; P <0.001). However, the characteristics of patients were not associated with the risk of postoperative nausea and vomiting. Conclusions The findings from this study showed that a history of pharyngitis increased the risk of FIC, while the use of lidocaine was associated with a reduced risk of FIC. The risk of postoperative nausea and vomiting was not affected by fentanyl use or patient characteristics.

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“…The lack of statistical significance in these groups may be explained by the small sample size and paucity of past studies. Premedicating with fentanyl leads to coughing, 36 which may interrupt the recording of airway events. In our study, the use of a subgroup analysis clarified these concerns, and the results were consistent in patients who were and who were not premedicated with fentanyl.…”

Section: Discussionmentioning

confidence: 99%

Adverse respiratory events with sevoflurane compared with desflurane in ambulatory surgery

Chen¹,

Chiang²,

Hung³

et al. 2020

European Journal of Anaesthesiology

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BACKGROUND An increasing number of studies have concluded that the number of adverse events in the upper airway caused by desflurane does not differ significantly from the number of adverse events caused by sevoflurane. The advantages of desflurane in ambulatory surgery should be reassessed. OBJECTIVES The aim of this study was to compare adverse respiratory events and recovery outcomes in patients undergoing desflurane or sevoflurane-based anaesthesia in ambulatory surgery. DESIGN A systematic review and meta-analysis of randomised controlled trials (RCTs). DATA SOURCES A systematic search for eligible RCTs in PubMed, Medline, Cochrane Central Register of Controlled Trials, ScienceDirect and Embase published up to June 2019. ELIGIBILITY CRITERIA RCTs investigating the occurrence of adverse respiratory events, including airway irritation, stridor, coughing, respiratory distress and laryngospasm, emergence agitation, postoperative nausea and vomiting (PONV), time to eye opening and time to discharge from the operation room after desflurane or sevoflurane-based anaesthesia. RESULTS Thirteen trials were included and analysed. A total of 634 patients were included in the desflurane group, and 633 patients in the sevoflurane group. The occurrence of respiratory complications was significantly higher with desflurane-based anaesthesia than with sevoflurane-based anaesthesia (Total n = 673, 20.0 vs. 12.8%, relative risk (RR) 1.59 (95% CI 1.15 to 2.20)) with low heterogeneity ( I 2 = 20%). There was no difference in the occurrence of emergence agitation (Total n = 626, 29.1 vs. 27.2%, RR 1.05 (95% CI 0.84 to 1.30)) or the incidence of PONV between the desflurane and sevoflurane groups (Total n = 989, 19.0 vs. 21.0%, RR 0.95 (95% CI 0.71 to 1.26)). Time to eye opening was significantly faster with desflurane than that with sevoflurane (Total n = 1072, mean difference = −3.32 min (95% CI −4.02 to −2.61)) with a substantial heterogeneity ( I 2 = 72.6%). There was no significant difference in the time to discharge from the operation room between the two groups (Total n = 1056, mean difference = −0.45 min (95% CI −5.89 to 4.99)). CONCLUSION Despite recent reports that there is no significant difference in adverse respiratory events between desflurane and sevoflurane, a pooled analysis revealed that desflurane resulted in a higher rate than sevoflurane. Therefore, the consequences of desflurane should not be neglected and its airway irritant properties should be taken into account. TRIAL REGISTRATION PROSPERO (CRD42019147939).

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Prophylactic Intravenous Lidocaine at Different Doses for Fentanyl-Induced Cough (FIC): A Meta-Analysis

Cited by 8 publications

References 34 publications

Mechanism and Management of Fentanyl-Induced Cough

Mechanism and Management of Fentanyl-Induced Cough

Risk Factors for Fentanyl-Induced Cough Following General Anesthesia in Adults: A Retrospective Study from a Single Center in China

Adverse respiratory events with sevoflurane compared with desflurane in ambulatory surgery

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