Objective:

Fentanyl is commonly used as a pre-induction adjunct, but can sometimes elicit cough. The existing literature about the incidence of fentanyl-induced cough (FIC) is extremely diverse and the results of clinical trials are conflicting. The purpose of our study was to investigate the effects of intravenous pre-induction doses (2 µg/kg) of fentanyl given with different injection velocities on the incidence and severity of FIC in Turkish population.

Material and Methods:

Following local ethical approval and obtaining written informed consents of the patients, 210 ASA I-III, 18-75 year- old patients undergoing general anesthesia for elective surgery were enrolled into this randomized placebo- controlled study. The exclusion criteria included, history of bronchial asthma or chronic obstructive lung disease, upper respiratory tract infection, smoking, and angiotensin converting enzyme inhibitor use. No premedication was used before surgery. Patients received either 2 µg/kg fentanyl injected over 2 sec, 20 sec or the same volume saline placebo (NaCl % 0.9) injected over 2 sec in Groups I, II, and III respectively. After completion of injections, the onset time and intensity of coughing was recorded by a blinded observer for 1 minutes. Severity of coughing was graded based on the number of coughs as mild (1-2), moderate (3-5), severe (≥5). Statistical analyses were performed with chi- square and independent sample t tests. P<0,05 was regarded as statistically significant.

Results:

The mean onset time of coughing was 21±7,71 seconds after the injections. The frequencies of coughing were 11.4 %, 8.6 %, 0 % in Groups I,II, and III respectively.

Conclusion:

According to our study, the mean incidence of coughing in the study participants after 2 µg/kg intravenous fentanyl was 10 % which is in-between European and Far East-Asiatic populations.

Keywords: Fentanyl, coughing