Physiology of Alfentanil-induced Rigidity

Benthuysen, James L.; Smith, N. Ty; Sanford, Theodore J.; Head, N.; Dec-Silver, H.

doi:10.1097/00000542-198604000-00005

Cited by 124 publications

(48 citation statements)

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“…This is in contrast to a previous study in which the authors reported an incidence of muscle rigidity of 7% when administering an infusion of remifentanil 1 mg.kg ¹1 .min ¹1 followed by propofol 0.5-1 mg.kg ¹1 [14]. The higher dose of propofol (2 mg.kg ¹1 ) administered before the bolus of remifentanil may prevent or attenuate opioid-induced muscle rigidity as shown with a combination of benzodiazepines and barbiturates [15,16].…”

Section: R Alexander Et Al • Remifentanil Vs Alfentanil For Intubationcontrasting

confidence: 80%

Comparison of remifentanil with alfentanil or suxamethonium following propofol anaesthesia for tracheal intubation

et al. 1999

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SummarySixty ASA physical status I and II, premedicated patients were administered propofol 2 mg.kg ¹1 and remifentanil 2 mg.kg ¹1 (group R), alfentanil 50 mg.kg ¹1 (group A) or suxamethonium 1 mg.kg ¹1 (group S) as a rapid bolus. One minute after study drug administration, tracheal intubation was performed. Intubation conditions were then scored. Excellent or good conditions were observed in only 35% in group R compared with groups S and A (100% and 85%, respectively; p < 0.001). The haemodynamic response to tracheal intubation was blunted in groups R and A compared with group S (p < 0.001). The mean heart rate in groups R and A was significantly lower than group S (p < 0.001). We conclude that remifentanil 2 mg.kg ¹1 given as a rapid bolus will not produce intubating conditions as good as those obtained with alfentanil 50 mg.kg ¹1 or suxamethonium 1 mg.kg ¹1 if administered after propofol 2 mg.kg ¹1 .

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Section: R Alexander Et Al • Remifentanil Vs Alfentanil For Intubationcontrasting

confidence: 80%

Comparison of remifentanil with alfentanil or suxamethonium following propofol anaesthesia for tracheal intubation

et al. 1999

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“…Another possible mechanism may be the release of histamine from lung mast cells, as inhalation of metered doses of sodium cromoglicate, (which is known to inhibit degranulation of mast cells), has been shown to decrease the incidence of cough [4]. A further mechanism may be the sudden adduction of the vocal cords or supraglottic obstruction by soft tissue caused by opioid-induced muscle rigidity [13].…”

Section: Discussionmentioning

confidence: 99%

The effect of pre‐emptive use of minimal dose fentanyl on fentanyl‐induced coughing

Hung¹,

Chen

Lin

et al. 2009

Anaesthesia

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SummaryWe performed a randomised, double-blind study to evaluate the effect of the pre-emptive use of minimal dose intravenous fentanyl (25 lg) on the incidence of cough caused by a larger bolus of intravenous fentanyl. Six hundred patients were randomly assigned to one of three groups to receive either 0.5 ml saline 0.9% 1 min before administration of fentanyl 150 lg (3 ml), or pre-emptive fentanyl 25 lg (0.5 ml) 1 min before administration of fentanyl 125 lg or 150 lg. The incidence of fentanyl-induced cough was significantly lower in both pre-emptive groups (7 (3.5%) for 125 lg fentanyl and 15 (7.5%) for 150 lg fentanyl) than in the saline group (37 (18.5%); p = 0.001). We conclude that pre-emptive use of fentanyl 25 lg, administered 1 min before bolus injection of fentanyl (125 or 150 lg), can effectively suppress fentanyl-induced cough.

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“…15 Despite a wide range of mechanistic studies, only im morphine, or inhalational treatments, including terbutaline, salbutamol, beclomethasone and sodium chromoglycate, were shown to attenuate the cough reflex. [2][3][4] Although the bronchodilating effect of lidocaine has been questioned, 16 iv lidocaine was proved to be a suppressant of coughing during tracheal intubation.…”

Section: Méthode : Cent Dix-huit Patients Ont éTé Répartis Au Hasard mentioning

confidence: 99%

Intravenous lidocaine and ephedrine, but not propofol, suppress fentanyl-induced cough

Lin

Sun

Chan

et al. 2004

Can J Anesth/J Can Anesth

119

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P Pu ur rp po os se e: : The aim of this study was to evaluate the effectiveness of lidocaine, propofol and ephedrine in suppressing fentanyl-induced cough.M Me et th ho od ds s: : One hundred and eighteen patients were randomly assigned into four groups and the following medications were given intravenously: patients in Group I (n = 31) received normal saline 2 mL, Group II (n = 29) received lidocaine 2 mg·kg and Group IV (n = 28) received ephedrine 5 mg. At one minute after the study medication, fentanyl 2.5 µg·kg -1 was given intravenously within two seconds. The occurrence of cough and vital sign profiles were recorded within two minutes after fentanyl bolus by an anesthesiologist blinded to study design.R Re es su ul lt ts s: : Sixty-five percent of patients in the placebo group had cough, whereas the frequency was significantly decreased in Groups II (14%) and IV (21%). Although a numerically lower frequency of cough was noted in Group III (37%), it was not statistically different from that of the placebo group. SpO 2 decreased significantly in patients of Group III compared to placebo; one patient experienced hypoxemia necessitating mask ventilation. Patients in Group III showed a decrease in heart rate and systolic blood pressure (2 beats·min

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Physiology of Alfentanil-induced Rigidity

Cited by 124 publications

References 0 publications

Comparison of remifentanil with alfentanil or suxamethonium following propofol anaesthesia for tracheal intubation

Comparison of remifentanil with alfentanil or suxamethonium following propofol anaesthesia for tracheal intubation

The effect of pre‐emptive use of minimal dose fentanyl on fentanyl‐induced coughing

Intravenous lidocaine and ephedrine, but not propofol, suppress fentanyl-induced cough

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