Efficacy of dezocine on preventing opioid-induced cough during general anaesthesia induction: a PRISMA-compliant systematic review and meta-analysis

Abstract

ObjectivesTo systematically review the effects of dezocine (DZC) on the occurrence rate and severity of opioid-induced cough (OIC).DesignSystematic review and meta-analysisData sourcesPubMed, Embase, Cochrane Library, Ovid, Web of Science as well as Chinese BioMedical Literature & Retrieval System, China National Knowledge Infrastructure, Wanfang and VIP Data were searched from 1978 to 31 December 2020.Inclusion criteriaAll randomised controlled trials (RCTs) comparing DZC with placebo on the occurrence rate and severity of OIC.Data analysisAll data were analysed by using RevMan V.5.3. Each outcome was tested for heterogeneity, and randomised-effects or fixed-effects model was used in the presence or absence of significant heterogeneity.ResultsOur search yielded 33 RCTs including 4442 patients, and 2521 patients were allocated into the DZC group and 1921 into the control group. Fentanyl was administrated in 1880 patients and sufentanil in 2562 patients during the induction of general anaesthesia. The meta-analysis demonstrated that DZC significantly reduced the occurrence rate of OIC induced by either fentanyl (8.8% vs 49.7%, OR=0.07, 95% CI 0.04 to 0.12, p<0.00001) or sufentanil (5.0% vs 41.5%, OR=0.07, 95% CI 0.04 to 0.12, p<0.00001). The meta-analysis also indicated that the occurrence rate of mild, moderate and severe OIC in the DZC group was remarkably lower than that of the control group (mild: 3.6% vs 13.6%, OR=0.19, 95% CI 0.14 to 0.25, p<0.00001; moderate: 2.0% vs 13.6%, OR=0.12, 95% CI 0.09 to 0.18, p<0.00001; severe: 1.0% vs 13.9%, OR=0.08, 95% CI 0.05 to 0.12, p<0.00001). Additionally, the current meta-analysis indicated that DZC pretreatment was not associated with increased occurrence rate of adverse effects (7.0% vs 4.2%, OR=2.34, 95% CI 0.60 to 9.14, p=0.22) except for dizziness (11.8% vs 0%, OR=8.06, 95% CI 1.40 to 46.35, p=0.02).ConclusionThis meta-analysis demonstrated that DZC significantly inhibited OIC and may be used to manage OIC. More high-quality RCTs are needed to complement the safety of DZC.PROSPERO registration numberCRD42019141255.

Preoperative fractional exhaled nitric oxide can predict postoperative cough-related quality of life and its recovery for early-stage non-small cell lung cancer patients: a longitudinal study

“…Intravenous bolus injections of opioids (e.g. fentanyl, sufentanil, remifentanil and alfentanil), are widely used in the induction and maintenance of anesthesia, have been reported to cause the development of postoperative cough [32,33]. Although this study failed to corroborate above risk factors, we did observe that the longer duration of anesthesia may be associated with a greater risk of postoperative cough, in agreement with many previous studies [7,9].…”

“…exaggerated laryngeal re exes, awake extubation, the presence of a tracheal tube during emergence from anesthesia and the use of propofol during awake tracheal intubation [21,22]. Intravenous bolus injections of opioids (e.g., fentanyl, sufentanil, remifentanil and alfentanil), are widely used in the induction and maintenance of anesthesia, have been reported to cause the development of postoperative cough [23,24].…”

Anesthesia management of patients undergoing thoracic endovascular aortic repair: A retrospective analysis of single center

“…[20] Although dezocine is not a well- known drug in Western countries, it is widely applied as perioperative pain analgesic agent in China for decades. [20]…”

“…[20] Although dezocine is not a well-known drug in Western countries, it is widely applied as perioperative pain analgesic agent in China for decades. [20] Maintenance of general anesthesia is a combination of sevoflurane and intravenous anesthetics in almost all patients. Sufentanil was used for intraoperative analgesia in all patients.…”

“…[18] Dezocine significantly reduced the incidence of etomidate-induced myoclonus [19] and inhibited opioid-induced cough. [20] Although dezocine is not a well-known drug in Western countries, it is widely applied as perioperative pain analgesic agent in China for decades. [20] Maintenance of general anesthesia is a combination of sevoflurane and intravenous anesthetics in almost all patients.…”