Incidence of Fentanyl-induced Cough and Effect of Dose: Randomized Placebo-controlled Trial

Abstract

Objective:Fentanyl is one of the opioids commonly used in the induction of general anesthesia and can cause coughing. The cough that occurs can be a problem in patients for whom it is necessary to avoid pressure increase. This study aimed to determine the incidence of fentanyl-induced cough (FIC) and the difference between the doses used.Method:This prospective randomized placebo-controlled trial included 750 ASA I-II patients aged 18-65 years who underwent elective surgery under general anesthesia. The patients were randomly divided into three groups. 1 μg kg-1 fentanyl was used to induce the patients in group 1, and 2 μg kg-1 fentanyl was used for the induction of the patients in group 2. In the installation of patients in group K, the control group, fentanyl was not used, and a placebo was administered. All patients were observed for 60 seconds after fentanyl injection. The cough severity (mild: 1-2, moderate: 3-4, severe: >5 times), time of cough and demographic data of the patients were recorded and compared.Results:Demographic data were similar among the groups. Cough was observed in 15 patients (6%) in group 1 and 80 patients (32%) in group 2. Incidences of FIC were 6%, 32%, and 0% in groups 1, 2, and K, respectively. While all of group 1 was mild, 82% of the cough observed in group 2 was mild, and 18% was moderate. The incidence and severity of cough in group 2 were significantly higher than in group 1 (p<0.001).Conclusion:Reducing the dose of fentanyl significantly decreases the severity and incidence of cough. We recommend reducing the induction dose to avoid undesirable pressure increases such as intracranial and intraocular surgeries.

Keywords

• cough
• fentanyl
• general anesthesia