Research Article

Preoperative Oral Passiflora Incarnata Reduces Coughing Following Extubation: A Double Blind, Placebo-Controlled Study


Background: The incidence of coughing following extubation can result in a number of undesirable side effects. Therefore, the development of antitussive premedication may be desirable.
Methods: In this study, 138 patients were randomized into two groups to receive either oral Passiflora incarnata (500 mg, PassipyTM IranDarouk) (n = 69) or placebo (n = 69) as premedication, 120 min before surgery. After extubation, all patients were observed to record the incidence of coughing during a 15 minute period. Hemodynamic variables were recorded before induction of anesthesia, 1 minute following intubation, and 5 minutes after extubation.
Results: The demographic characteristics of patients, ASA physical status, duration of surgery, hemodynamic variables were similar in the two groups. The incidence of cough following extubation was significantly lower in the passiflora group compared to the control group (P <0.001).
Conclusion: In outpatient surgery, administration of oral Passiflora incarnata as a premedication reduces incidence of coughing following extubation.

Fagan C, Frizelle HP, Laffey J, Hannon V, Carey M. The effects of intracuff lidocaine on endotracheal-tube-induced emergence phenomena after general anesthesia. Anesth Analg. 2000; 91(1):201-5.

Gonzalez RM, Bjerke RJ, Drobycki T, Stapelfeldt WH, Green JM, Janowitz MJ, et al. Prevention of endotracheal tube-induced coughing during emergence from general anesthesia. Anesth Analg. 1994; 79(4):792-5.

Lowrie A, Johnston PL, Fell D, Robinson SL. Cardiovascular and plasma catecholamine responses at tracheal extubation. British journal of anaesthesia. 1992; 68(3):261-3.

Leech P, Barker J, Fitch W. Changes in intracranial pressure and systemic arterial pressure during the termination of anaesthesia. Br J Anaesth. 1974; 46(4):315-6.

Bidwai AV, Bidwai VA, Rogers CR, Stanley TH. Blood-pressure and pulse-rate responses to endotracheal extubation with and without prior injection of lidocaine. Anesthesiology 1979; 51:171-3

Steinhaus JE, Gaskin I. A study of intravenous lidocaine as a suppressant of cough reflex. Anesthesiology. 1963; 24:285-90

Gefke K, Andersen LW, Friesel E. Lidocaine given intravenously as a suppressant of cough and laryngospasm in connection with extubation after tonsillectomy. Acta Anaesthesiol Scand. 1983; 27(2):111-2.

Sumathi P A, Shenoy T, Ambareesha M, Krishna M.controlled comparison between betamethasone gel and lidocaine jelly applied over tracheal tube to reduce postoperative sore throat,cough,and hoarseness of voice. Br J Anaesth. 2008; 100(2):215-8.

Minogue SC, Ralph J, Lampa MJ. Laryngotracheal topicalization with lidocaine before intubation decreases the incidence of coughing on emergence from general anesthesia. Anesth Analg. 2004; 99(4):1253-7.

Hosseini L, Yazarlu K, Eslami B, Marzony SG. The Relation between Ketamine Spraying on the Endotracheal Tube Cuff and Reduced Postoperative Sore Throat, Cough and Hoarseness in Parturient Patients. Archives of Anesthesiology and Critical Care. 2015;1(1):8-12.

Fisher AA, Purcell P, Le Couteur DG. Toxicity of Passiflora incarnata L. J Toxicol Clin Toxicol. 2000; 38(1):63-6.

Dhawan K,Sharma A. Antitussive actvity of the methanol extract of passiflora incarnata leaves. Fitoterapia. 2002; 73(5):397-9.

Watson RR, Zibadi S, Rafatpanah H, Jabbari F, Ghasemi R, Ghafari J, et al. Oral administration of the purple passion fruit peel extract reduces wheeze and cough and improves shortness of breath in adults with asthma. Nutr Res. 2008; 28(3):166-71.

Dhawan K, Kumar S, Sharma A. Antiasthmatic activity of the methanol extract of leaves of passiflora incarnata. Phytother Res. 2003; 17(7):821-2.

Zibadi S, Watson RR. Passion fruit (Passiflora edulis): composition, efficacy and safety (Review). Evid Based Integrative Med. 2004; 1(3): 183-7.

Smith GW, Chalmers TM, Nuki G. Vasculitis associated with herbal preparation containing Passiflora extract. Brit J Rheumat. 1993; 32(1):87-8.

Blumenthal M. The Complete German Commission E Monographs. Therapeutic Guide to Herbal Medicines. Austin: American Botanical council, 1998.

IssueVol 3 No 3 (2017): Summer QRcode
SectionResearch Article(s)
cough tracheal extubation passiflora incarnate

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How to Cite
Saliminia A, Azimaraghi O, Ghadimi M, Kaafi Kang N, Movafegh A. Preoperative Oral Passiflora Incarnata Reduces Coughing Following Extubation: A Double Blind, Placebo-Controlled Study. Arch Anesth & Crit Care. 2017;3(3):338-341.