Comparison of the Premedication Effect of Propofol and Dexamethasone on Reducing Fentanyl-Induced Cough

Abstract

Background: The incidence of fentanyl-induced cough (FIC) during induction of general anesthesia is 28-65%. Therefore, prevention of this complication is required. In this study, the effects of propofol and dexamethasone on the frequency and severity of fentanyl-induced cough were assessed in patients undergoing general anesthesia. Methods: During a double-blind, randomized clinical trial study, 99 patients aged 18-64 years with classes I and II of American Society of Anesthesiologists (ASA) classification, who were undergoing general anesthesia with fentanyl, were investigated. Patients were randomly divided equally into 3 groups receiving propofol (1.5 mg/kg), dexamethasone (0.1 mg/kg), and placebo (5 ml normal saline). All drugs were administered 1 minute before administration of 2.5 µg/kg fentanyl. Vital signs, and frequency and intensity of cough were measured and recorded. Statistical analysis was performed using one-way ANOVA and Kruskal-wallis tests. Findings: The incidence of fentanyl-induced cough was 27.3%, 78.8%, and 84.8% in propofol, dexamethasone, and placebo groups, respectively (P< 0.010). The severity of cough was significantly lower in the propofol group (mild: 72.7%, moderate: 27.3%, and severe: 0%) compared to the placebo group (mild: 18.2%, moderate: 72.7%, and severe: 9.1%) (P < 0.010). Furthermore, there were significant differences between three groups in the variations of hemodynamic parameters (P < 0.050). Conclusion: It seems that administration of low-dose propofol (10 mg) can reduce the frequency and intensity of fentanyl-induced cough during induction of general anesthesia.

Keywords

• Cough
• Dexamethasone
• Fentanyl
• Propofol
• Premedication