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Dose‐dependent attenuation by fentanyl on cough during emergence from general anesthesia
Author(s) -
YOO Y.C.,
NA S.,
JEONG J.J.,
CHOI E.M.,
MOON B.E.,
LEE J.R.
Publication year - 2011
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.2011.02529.x
Subject(s) - fentanyl , medicine , anesthesia , sevoflurane , respiratory rate , heart rate , anesthetic , blood pressure
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 ( F 0, F 1, F 1.5, and F 2) 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 C ochran– A rmitage 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 M antel– H aenszel 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 F 2 was comparable with that in F 1 and F 1.5. Respiratory rate (9 ± 2 bpm) and extubation time (11.9 ± 1.8 min) in F 2 were only different from those in F 0 (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.