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Dose-dependent attenuation by fentanyl on cough during emergence from general anesthesia

Authors
 Y.-C. YOO  ;  S. NA  ;  J.-R. LEE  ;  B.-E. MOON  ;  E.-M. CHOI  ;  J.-J. JEONG 
Citation
 Acta Anaesthesiologica Scandinavica, Vol.55(10) : 1215-1220, 2011 
Journal Title
 Acta Anaesthesiologica Scandinavica 
ISSN
 0001-5172 
Issue Date
2011
Abstract
BACKGROUND: Although fentanyl suppresses tracheal tube-induced cough during anesthetic recovery, it has not been proven if its antitussive effect is dose dependent and complication free. The purpose of this study is to evaluate the relationship between fentanyl doses and cough suppression during emergence from sevoflurane anesthesia. METHODS: Sixty patients undergoing thyroidectomy were randomly allocated to one of four groups (F0, F1, F1.5, and F2) according to the fentanyl dose (0 mcg/kg, 1 mcg/kg, 1.5 mcg/kg, or 2 mcg/kg). Fentanyl was administered immediately after sevoflurane discontinuation. Coughing was assessed throughout the periextubation period. The relationship between fentanyl dose and incidence of cough was analyzed using Cochran-Armitage trend test. Incidence of more than 30% elevation of mean arterial pressure (MAP) and heart rate (HR), awakening time, extubation time, and respiratory rate after extubation were recorded and compared using Mantel-Haenszel chi-square test and one-way analysis of variance. RESULTS: Fentanyl suppressed emergence cough in a dose-related manner (P = 0.002), and the ED(50) and ED(90) were 1.1 mcg/kg and 2.1 mcg/kg, respectively. The higher dose of fentanyl further reduced the number of patient with MAP and HR elevation (P = 0.003 and 0.005, respectively). Awakening time (8.4 ± 1.9 min) in F2 was comparable with that in F1 and F1.5. Respiratory rate (9 ± 2 bpm) and extubation time (11.9 ± 1.8 min) in F2 were only different from those in F0 (13 ± 3 bpm and 10.4 ± 1.1 min, respectively). CONCLUSIONS: Fentanyl suppressed cough in a dose-related manner during recovery from general sevoflurane anesthesia, and 2 mcg/kg may be considered as a proper dose.
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/94578
DOI
10.1111/j.1399-6576.2011.02529.x
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실)
Yonsei Authors
나성원(Na, Sung Won) ; 유영철(Yoo, Young Chul) ; 이정림(Lee, Jeong Rim) ; 정종주(Jeong, Jong Ju)
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Full Text
http://onlinelibrary.wiley.com/doi/10.1111/j.1399-6576.2011.02529.x/abstract
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