Comparing the different oxycodone doses of prevent oxycodone for prevention of preventing fentanyl‐induced cough during induction of general anaesthesia

Abstract

Background: Fentanyl-induced cough (FIC) usually occurs after the intravenous administration of fentanyl during general anaesthesia induction. It is a transient condition depending on the fentanyl administration dose and injection speed. Oxycodone can also prevent FIC because it has been proven to treat coughing. This study aimed to evaluate the efficacy of different oxycodone doses to prevent FIC during general anaesthesia induction. Methods: In a double-blind randomised controlled trial, 210 adult patients who were undergoing elective surgery, classified as American Society of Anaesthesiologists physical status I-II, and aged 20-65 years were randomly assigned into five equally sized groups: Sham group, Group Ⅰ, Group II, Group III and Group IV. Groups Ⅰ-IV were each intravenously injected with oxycodone 0.025, 0.05, 0.075 and 0.100 mg/ kg, while an equal volume of normal saline was given instead of oxycodone in the Sham group. Five minutes later, fentanyl 3 μg/kg was intravenously injected within 5 seconds, then, 2 minutes later the other drugs were administered for general anaesthesia induction. The occurrence and severity of coughing were observed within 2 minutes of the fentanyl injection. Vital signs and intensities of coughing were recorded and analysed. Results: Coughing incidences were each 57.1, 50, 42.8, 33.3 and 21.4% in the Sham group and Groups Ⅰ-IV. Significant differences were found in the incidences of coughing between the Sham group and Groups III-IV. No significant differences in FIC incidences have been detected between the Sham group and Groups Ⅰ-II. However, no significant difference in FIC incidence existed between Group III and Group IV. Cough severities in Groups III and IV were significantly lower than in Groups Ⅰ and II (P < .05). No significant differences existed in the hypotension or severe bradycardia incidences during anaesthesia induction among the five groups (P > .05). Conclusion: Oxycodone 0.075 mg/kg provided more effective FIC prevention during general anaesthesia induction. How to cite this article: Dai B, Cao X. Comparing the different oxycodone doses of prevent oxycodone for prevention of preventing fentanyl-induced cough during induction of general anaesthesia. Int J Clin Pract.

WITHDRAWN: Comparison of a small dose of oxycodone and sufentanil for the prevention of sufentanil-induced cough during general anesthesia induction: a prospective randomized controlled trial

“…There are a few studies associated with oxycodone inhibiting opioid-induced cough, and the proper antitussive dosage remains controversial. Dai et al [14] concluded that 0.075 mg/kg oxycodone can prevent FIC effectively in general anesthesia induction and that the effect of suppression was dose dependent. However, another study found that oxycodone dosages of 0.025, 0.050, and 0.075 mg/kg reduce the incidence and severity of FIC [26].…”

“…Oxycodone is a derivative of thebaine and is mainly used to alleviate perioperative pain. Oxycodone inhibits μ and κ agonists and exerts obvious antitussive effects by directly acting on the cough center of the medulla oblongata [14]. A previous study found that pre-emptive use of a small dose of opioids may suppress opioid-induced cough without applying additional drugs [10,15,16].…”

Comparison of a Small Dose of Oxycodone and Sufentanil for the Prevention of Sufentanil-Induced Cough during General Anesthesia Induction: A Prospective Randomized Controlled Trial

“…There are a few studies associated with oxycodone inhibiting opioid-induced cough, and the proper antitussive dosage remains controversial. Dai et al [14] concluded that 0.075 mg/kg oxycodone could prevent SIC effectively in general anesthesia induction and that the effect of suppression was dose-dependent. However, another study found that 0.025, 0.050, and 0.075 mg/kg of oxycodone could reduce the incidence and severity of SIC [26].…”

“…Oxycodone is a derivative of thebaine and is mainly used to alleviate perioperative pain. It can inhibit μ and κ agonists and exert obvious antitussive effects by directly acting on the cough center of the medulla oblongata [14]. A previous study found that preemptive use of a small dose of opioids could suppress opioid-induced cough without applying additional drugs [10,15,16].…”

Mechanism and Management of Fentanyl-Induced Cough

“…According to a study by Qing et al, the incidence of cough can be reduced from 22.6% to 4.3% with pre-injection of 0.5 mg•kg −1 pentazocine (Ai et al, 2010). In addition, other opioid agonists-antagonists, such as butorphanol, nalbuphine, and oxycodone can also effectively suppress FIC (Cheng et al, 2016;Dai and Cao, 2020;Wang et al, 2020;Yin and Zhang, 2019).…”