No relationship between the incidence of fentanyl-induced cough and smoking

Boris Pokhis, Hans-Bernd Hopf

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DOI: 10.4236/health.2009.13031                

Abstract

The purpose of the study was to investigate whether or not the incidence of cough after intra-venous fentanyl depends on the patient’s smoking state and the speed of injection. 530 ASA class I-III patients free of bronchial hyperreactivity and res-piratory tract infection undergoing general anes-thesia for elective surgery were randomized to 1.5 g.kg-1 fentanyl injected over 2, 5 or 10 sec or pla-cebo via a peripheral intravenous cannula. The endpoint was cough within 5 min after completion of injection. Statistical evaluation was performed by factorial ANOVA and chi-square-test. Assuming around 25% smokers in our patient population calculated patient sample size was 340 per group. The study was terminated for futility after enrol-ment of 530 patients since an interims analysis yielded an incidence of cough of 2 % both in smokers (n=174) and nonsmokers (n=356, p= 0,970), which was unrelated to the speed of injec-tion and not different from placebo.

Keywords

Cough, fentanyl induced; smoking; fentanyl induced cough; cough; fentanyl;

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	U. Sch?permeier, H. B. Hopf, (2008) Fentanyl-induced cough does not depend on injection speed: A randomised study. Acta Anaesthesiol Scand, 52, 1071-5.
[2]	P. W. Lui, C. H. Hsing, Y. C. Chu, (1996) Terbutaline inhalation suppresses fentanyl-induced coughing. Can J Anaesth, 43, 1216-9.
[3]	A. Agarwal, A. Azim, S. Ambesh, et al., (2003) Salbuta-mol, beclomethasone or sodium chromoglycate suppress coughing induced by iv fentanyl. Can J Anaesth, 50, 297-0.
[4]	C. S. Lin, W. Z. Sun, W. H. Chan, C. J. Lin, H. M. Yeh, M. S. Mok, (2004) Intravenous lidocaine and ephedrine, but not propofol, suppress fentanyl induced cough. Can J Anaesth, 51, 654-9.
[5]	C. K. Pandey, M. Raza, R. Ranjan, et al., (2004) Intrave-nous lidocaine suppresses fentanyl-induced coughing: a double-blind, prospective, randomized placebo-controlled study. Anesth Analg, 99, 1696-8.
[6]	J. A. Lin, C. C. Yeh, M. S. Lee, C. T. Wu, S. L. Lin, C. S. Wong, (2005) Prolonged injection time and light smoking decrease the incidence of fentanyl-induced cough. Anesth Analg, 101, 670-4.
[7]	H. C. Horng, C. S. Wong, K. N. Hsiao, B. K. Huh, C. P. Kuo, C. H. Cherng, C. T. Wu, (2007) Pre-medication with intravenous clonidine suppresses fentanyl-induced cough. Acta Anaesthesiol Scand, 51, 862-865.
[8]	H, B?hrer, F. Fleischer, P. Werning, (1990) Tussive effect of a fentanyl bolus administered through a central venous catheter. Anaesthesia, 45, 18-21.
[9]	W. T. Phua, B. T. Teh, W. Jong, T. L. Lee, W. A. Tweed, (1991) Tussive effect of a fentanyl bolus. Can J Anaesth, 38, 330-4.
[10]	S. J. Pocock, (1998) Clinical trials: A practical aproach. Chichester New York Brisbanae Toronto Singapore: John Wiley & Sons, Chapter 9, 123-141.