The effect of dilution and prolonged injection time on fentanyl‐induced coughing*

Abstract

SummaryThis study was designed to evaluate the effect of diluting fentanyl 50 lg.ml )1 to 25 or 10 lg.mlwith 0.9% saline and prolonged injection time on fentanyl-induced cough. Two hundred patients requiring general anaesthesia were randomly allocated into four groups: 50 lg.ml

The frequency of fentanyl-induced cough in children and its effects on tracheal intubation

“…Furthermore, we have shown that the frequency of fentanyl-induced cough with fentanyl administered at a dosage of one μg/kg in children (46.3%) was similar to, or larger than, the frequency of fentanyl-induced cough in adults after administration of dosages ranging from two μg/kg (28% ∼ 38.7%) [4,10], three μg/kg (32% ∼ 35 %) [5,9], to 5 μg/kg (43%) [8]. The results of this study showed that there were statistical differences in coughing patterns induced by varying dosages of fentanyl in children, suggesting that the dosage of fentanyl directly affected severity of cough rather than frequency.…”

“…Lin et al [14] suggested that age could be a confounding factor for fentanyl-induced cough, which was presented as heightened irritant receptor activity in their younger population, compared with Bohrer et al's study [6]. Yu et al [5] observed that infants and children had a higher frequency of cough induced by fentanyl in daily clinical practice. Our previous study also supports this high frequency of cough in children [12].…”

“…Its advantages include rapid onset and short duration of action, intense analgesia, cardiovascular stability, as well as the absence of a histamine release [1][2][3]. A number of reports have suggested that a pre-induction bolus dose of fentanyl causes coughing with varying degrees; this side effect, which is known to be transient and self-limiting in most patients, is also dose-dependent in adults [4][5][6][7][8][9][10][11].…”

Effects of a Priming Dose of Fentanyl during Anaesthesia on the Incidence and Severity of Fentanyl-Induced Cough in Current, Former and Non-Smokers

“…b Group 1 received a fentanyl 2 µg/kg bolus, groups 2, 3 and 4 received a priming dose of fentanyl 0.5 µg/kg followed by 1.5 µg/kg after 1, 2 or 3 min, respectively. 12 and the position of the injection site (peripheral as opposed to the central route) 13 have both been shown to reduce FIC. Patients in the present study were injected with undiluted fentanyl via the peripheral route (in the forearm) over 3 − 5 s. Age has been reported as a risk factor for FIC, 1,6,29 but the present study did not find such an association.…”

Suppressing Effect of Dextromethorphan or Clonidine on Fentanyl- Induced Coughing: A Double- Blind, Prospective, Randomized Placebo- Controlled Study

“…Fentanyl-induced cough could also be the result of a mechanical or chemical stimulation of sensory receptors within the respiratory tract; the afferent impulses from these receptors may activate a putative brainstem cough center [7]. Drugs such as ketamine, terbutaline, clonidine, dexamethasone, and lidocaine as well as performing some maneuvers such as a forced expiration against open glottis, dilution of fentanyl to 10 μg/ ml, and prolonged injection time have all been evaluated in reducing this fentanyl induced cough [8][9][10][11][12][13]. Dextromethorphan is an antitussive drug that is used for suppression of cough caused by minor throat and tracheo-bronchial irritation, especially after inhalation of any irritants.…”