Fentanyl-induced coughing and airway hyperresponsiveness.
BACKGROUND
The tussive effect of fentanyl, in sharp contrast to the antitussive effect that common opioids have, is not rarely seen in clinical anesthesia. Pretreatment with beta 2 agonist inhalation could dramatically suppress fentanyl-induced coughing. We hypothesized that airway hyperresponsiveness might exist in large proportion of the subjects who had experienced fentanyl-induced coughing during previous anesthesia.


METHODS
We designed a case-controlled matching study to investigate the correlation between fentanyl-induced coughing and airway hyperresponsiveness. Twenty-six consecutive subjects (ASA I-III), who experienced fentanyl-induced coughing during anesthesia in our hospital from 1999 to 2000, were enrolled in this study as the fentanyl-cough group. In all the subjects baseline spirometry was first obtained. Airway responsiveness was evaluated with either PC20 of methacholine challenge test or bronchodilator test. After matching age and sex, another 26 subjects without history of fentanyl-induced coughing during previous anesthesia were also enrolled in the study as the control group.


RESULTS
The proportion of airway hyperresponsiveness in fentanyl-cough group and control group was 30.77% and 19.23% respectively. After pairing of these two groups, McNemar test revealed no significant difference in the proportion of airway hyperresponsiveness between these two groups (P = 0.257).


CONCLUSIONS
From the analysis of the present study, we cannot prove that there is a direct correlation between fentanyl-induced coughing and airway hyperresponsiveness.
Tsou
Chih-Hsiang
CH
Department of Respiratory Therapy, Biostatistics Task Force and Information Services Center, Taipei Veterans General Hospital, No 201, Section 2, Shih-Pai Road, Taipei, Taiwan, R.O.C.
Luk
Hsiang-Ning
HN
Chiang
Shu-Chiung
SC
Hsin
Shih-Tai
ST
Wang
Jia-Horng
JH
D000293:Adolescent; D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000009:adverse effects*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects; D016535:Bronchial Hyperreactivity / Q000139:chemically induced*; D016084:Bronchoconstriction / Q000502:physiology; D003371:Cough / Q000139:chemically induced*; D005260:Female; D005283:Fentanyl / Q000009:adverse effects*; D006801:Humans; D008297:Male; D016210:Methacholine Chloride / Q000494:pharmacology; D008875:Middle Aged
D000701:Analgesics, Opioid; D000806:Angiotensin-Converting Enzyme Inhibitors; D016210:Methacholine Chloride; D005283:Fentanyl