Assessment of the Effect of Intravenous Lidocaine, Dexamethasone and Different Speeds of Injection on Fentanyl-Induced Cough During Cataract Surgery
AbstractBackground: Fentanyl which is frequently used during cataract surgery has been found to induce cough. The aim of this study was to evaluate the effect of IV lidocaine and dexamethasone and different speeds of injection of fentanyl on cough induced by this drug.Methods: In this randomized double blind clinical trial study, patients were allocated randomly to four groups to receive 1 mg.kg-1 lidocaine (group i), 0.1 mg.kg-1 dexamethasone (group II) and 5 cc normal saline as placebo (group III & IV) intravenously. Four minutes later, all patients were given 1.5 µg.kg-1 fentanyl intravenously. Fentanyl was administered within 15 seconds in group I-III and within 2 seconds in group IV. Incidence, number and intensity of cough were recorded. Heart rate and blood pressure were also recorded before administration of drug, 1 minute after administration of drug and 2 minutes after administration of fentanyl.Results: 139 patients were evaluated. There was no significant difference in demographic features of groups including age, weight, gender and also heart rates and blood pressures. Incidence and intensity of cough was significantly higher in group IV while there was no statistically considerable difference between other groups.Conclusion: This study demonstrated that slowing injection of fentanyl can effectively reduce the incidence of cough induced by drug; hereby administration of lidocaine or dexamethasone becomes unnecessary in this speed of injection. Additionally cough incidence after fentanyl injection is affected by patients' ethnicity.
Riordan P, Eva J, Whitcher PV. Vaughan & Asbury’s General Ophtalmology. 17th ed: teimourzadeh; 2008 2008. 172-7 p.
Maghsoudloo M, Eftekhar N, Ashraf MAN, Khan ZH, Sereshkeh HP. Does intravenous fentanyl affect Apgar scores and umbilical vessel blood gas parameters in cesarean section under general anesthesia? Acta Medica Iranica. 2011;49(8):517.
Takzare A, Soltani AE, Maleki A, Nooralishahi B, Kaheh F, Arab S, et al. Comparison of Propofol-Ketamine vs Propofol-Fentanyl for Pediatric Sedation during Upper Gastrointestinal Endoscopy. Archives of Anesthesiology and Critical Care. 2016;2(3):222-5.
Katzung BG, Masters SB, Trevor AJ. Basic & clinical pharmacology. 12th ed: Lange Medical Books/McGraw-Hill New York, NY, USA:; 2012. 543-64 p.
Ostadalipour A, Nikooseresht M, Maleki A, Jamshidi M, Rabies MAS, Spahbodi E, et al. Comparison of Paracetamol and Fentanyl for Postoperative Pain and Perioperative Events in Phacoemulsification Cataract Surgery. Archives of Anesthesiology and Critical Care. 2015;1(3):76-9.
Ei Baissari M, Taha SK, Siddik-Sayyid SM. Fentanyl-induced cough--pathophysiology and prevention. Middle East J. 2014.
Hung KC, Chen CW, Lin VH, Weng HC, Hsieh SW. The effect of pre‐emptive use of minimal dose fentanyl on fentanyl‐induced coughing. Anaesthesia. 2010;65(1):4-7.
Ambesh SP, Singh N, Gupta D, Singh P, Singh U. A huffing manoeuvre, immediately before induction of anaesthesia, prevents fentanyl-induced coughing: a prospective, randomized, and controlled study. British journal of anaesthesia. 2010;104(1):40-3.
Pandey CK, Raza M, Ranjan R, Singhal V, Kumar M, Lakra A, et al. Intravenous lidocaine 0.5 mg· kg-1 effectively suppresses fentanyl-induced cough. Canadian Journal of Anesthesia. 2005;52(2):172-5.
Haji A, Kimura S, Ohi Y. A model of the central regulatory system for cough reflex. Biological and Pharmaceutical Bulletin. 2013;36(4):501-8.
Oshima T, Kasuya Y, Okumura Y, Murakami T, Dohi S. Identification of independent risk factors for fentanyl-induced cough. Canadian Journal of Anesthesia. 2006;53(8):753-8.
Jung H, Kim J, Im K, Cho H, Kim J, Lee J. Effects of a priming dose of fentanyl during anaesthesia on the incidence and severity of fentanyl-induced cough in current, former and non-smokers. Journal of International Medical Research. 2011;39(6):2379-84.
Gu C, Zhou M, Wu H, Li F, Tang Q. Effects of different priming doses of fentanyl on fentanyl-induced cough: a double-blind, randomized, controlled study. Pharmacological Reports. 2012;64(2):321-5.
Collins V. In Principles of Anesthesiology. 3rd. Lea and Febiger Philadelphia, PA. 1993:518-59.
Sun L, Guo R, Sun L. The impact of prophylactic intravenous lidocaine on opioid-induced cough: a meta-analysis of randomized controlled trials. Journal of anesthesia. 2014;28(3):325-33.
Lin J-A, Chen F-C, Lee M-S, Horng H-C, Cherng C-H, Yeh C-C, et al. Intravenous dexamethasone pretreatment reduces fentanyl-induced cough. Journal of the Formosan Medical Association. 2007;106(8):649-55.
He L, Xu J-M, Dai R-P. Dexmedetomidine reduces the incidence of fentanyl-induced cough: a double-blind, randomized, and placebo-controlled study. Upsala journal of medical sciences. 2012;117(1):18-21.
Guler G, Aksu R, Bicer C, Tosun Z, Boyaci A. Comparison of the effects of ketamine or lidocaine on fentanyl-induced cough in patients undergoing surgery: a prospective, double-blind, randomized, placebo-controlled study. Current Therapeutic Research. 2010;71(5):289-97.
Sedighinejad A, Nabi BN, Haghighi M, Imantalab V, Hadadi S, Sayar RE, et al. Propofol is effective to depress fentanyl-induced cough during induction of anesthesia. Anesthesiology and pain medicine. 2013;2(4):170-3.
Yu H, Yang XY, Zhang X, Li Q, Zhu T, Wang Y, et al. The effect of dilution and prolonged injection time on fentanyl‐induced coughing*. Anaesthesia. 2007;62(9):919-22.
Ai Q, Hu Y, Wang Y, Wu S, Qin Z, Wang J, et al. Pentazocine pretreatment suppresses fentanyl-induced cough. Pharmacological reports. 2010;62(4):747-50.
Taregh A, et al. The effect of IV Lidocaine prodrug and slow injection rate of fentanyl on fentanyl-induced cough in anesthesia. Scientific and research journal of ilam university of medical sciences. 2007;14(4):31-5.[persian]
Schäpermeier U, Hopf HB. Fentanyl induced cough does not depend on injection speed: a randomized study. Acta Anaesthesiologica Scandinavica. 2008;52(8):1071-5.
Lin J-A, Yeh C-C, Lee M-S, Wu C-T, Lin S-L, Wong C-S. Prolonged injection time and light smoking decrease the incidence of fentanyl-induced cough. Anesthesia & Analgesia. 2005;101(3):670-4.
Tang Q, Qian Y, Zhang Q, Yang J, Wang Z. Effects of different priming doses of propofol on fentanyl-induced cough during anesthesia induction: a preliminary randomized controlled study. Upsala journal of medical sciences. 2010;115(2):121-4.
Shen J-C, Xu J-G, Zhou Z-Q, Liu H-J, Yang J-J. Effect of equivalent doses of fentanyl, sufentanil, and remifentanil on the incidence and severity of cough in patients undergoing abdominal surgery: A prospective, randomized, double-blind study. Current Therapeutic Research. 2008;69(6):480-7.
Nouruzi V, Mohamadian A. Effect of intravenous Dexamethasone in deminishing alfentanyl-induced cough during induction of general anesthesia. journal of iranian society anaesthesiology and intensive care.31(70):55-61.
Choudhuri R, Kar SK, Dasgupta CS, Adhikari D, Ganguly T. Influence of Speed of Fentanyl Citrate Injection before Induction of Anesthesia on Fentanyl-Induced Cough: a Prospective, Randomized, Double Blinded Study. La Prensa Medica. 2015;2015.
Kim D-H, Yoo J-Y, Moon B-K, Yoon B-H, Kim J-Y. The effect of injection speed on remifentanil-induced cough in children. Korean journal of anesthesiology. 2014;67(3):171-4.
Gecaj-Gashi A, Nikolova-Todorova Z, Ismaili-Jaha V, Gashi M. Intravenous lidocaine suppresses fentanyl-induced cough in Children. Cough. 2013;9(1):20.
Yu M-S, Kim JY, Kim HY. Intravenous dexamethasone pretreatment reduces remifentanil induced cough. Korean journal of anesthesiology. 2011;60(6):403-7.