BackgroundFentanyl-induced cough (FIC) is a transient condition with a reported incidence of 18% to 65% depending on the dose and route of administration of fentanyl. Nonpharmacological methods to prevent FIC are more cost-effective than medications. Dilution of fentanyl has a proven role in the prevention of FIC. Acupressure can also prevent FIC because it has a proven role in the treatment of cough.MethodsThis study included 225 female patients with an American Society of Anesthesiologists physical status of I or II who were randomly divided into 3 groups of 75 patients each. Patients in the control group received undiluted fentanyl at 3 µg/kg, patients in the acupressure group received undiluted fentanyl at 3 µg/kg with acupressure, and patients in the dilution group received diluted fentanyl at 3 µg/kg. Coughing was noted within 2 min of fentanyl administration. The severity of FIC was graded as mild (1–2 coughs), moderate (3–4 coughs), or severe (≥5 coughs). The timing of coughs was also noted.ResultsThe incidence of FIC was 12.7% in the control group, 6.8% in the dilution group, and 1.3% in the acupressure group. The difference in the incidence of cough was statistically significant (P = 0.008) between the control and acupressure groups. The difference in the severity of cough among the groups was not statistically significant. The median onset time of cough among all groups was 9 to 12 seconds.ConclusionsThe application of acupressure prior to administration of fentanyl significantly reduces the incidence of FIC. Dilution of fentanyl also reduces the incidence of FIC, but the difference is not statistically significant.
Aim and objective:We evaluated the effect of preoperative single-dose pregabalin (PG) on postoperative pain in patients undergoing on-pump coronary artery bypass graft (CABG) surgery.
Materials and methods:In this double-blind study, 60 adult patients scheduled for elective on-pump CABG surgery were randomized into two groups of 30 each, viz., PG and placebo (PL). Patients received either oral PG 150 mg or a PL, 1 hour before surgery. All patients received general anesthesia. Postoperative pain relief was provided with intravenous tramadol 50 mg 8 hourly. Postoperative pain was assessed, both at rest and during coughing, with the 10-point verbal rating scale (VRS) at 6, 12, 18, and 24 hours after extubation. Time to extubation, pain scores, requirement of additional analgesics, and adverse effects were compared using chi-square test, unpaired t test, and Mann-Whitney U test.
Results:The time to extubation was significantly prolonged in the PG group compared with PL (9.84 ± 1.88 vs 8.66 ± 2.12 hours, p = 0.027). The mean VRS scores at rest and during coughing were significantly lower in the PG group compared with PL (p < 0.05). However, the requirement of additional analgesics, such as paracetamol or tramadol was similar in the two groups.
Conclusion:A single preoperative oral dose of PG 150 mg was effective in reducing postoperative pain in patients undergoing on-pump CABG compared with a PL.
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