Intravenous lidocaine 0.5 mg.kg-1 effectively suppresses fentanyl-induced cough.
OBJECTIVE
To evaluate the minimal dose of lidocaine required for suppression of fentanyl-induced cough.


METHODS
320 ASA I and II patients, non-smokers of both sexes scheduled for elective surgery between the ages of 18 to 60 yr were randomly allocated into four equal groups. The patients were assigned to receive lidocaine 0.5 mg.kg(-1) (Group I), 1.0 mg.kg(-1)(Group II), 1.5 mg.kg(-1) (Group III) or placebo (Group IV) over five seconds, one minute prior to the administration of fentanyl 3 microg.kg(-1) in a randomized and double-blind fashion. Any episode of cough was classified as coughing and graded as mild (1-2) moderate (3-4) or severe (5 or more). The data were analyzed by test of proportion.


RESULTS
Eleven, 12, 11 and 28 patients (13.75%, 15%, 13.75% and 35%) had cough in Groups I, II, III and IV respectively (P < 0.05 Groups I, II, III vs IV). There was no significant difference in the incidence and severity of cough among the lidocaine pretreated groups (P > 0.05).


CONCLUSIONS
The results of our study suggest that iv lidocaine 0.5 mg.kg(-1) is the minimal dose required to suppress fentanyl-induced cough when administered one minute prior to fentanyl. Any further increase in the lidocaine dose does not reduce the incidence or severity of fentanyl-induced cough.
Pandey
Chandra Kant
CK
Department of Anaesthesiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226014, India. ckpandey@sgpgi.ac.in
Raza
Mehdi
M
Ranjan
Rajeev
R
Singhal
Vinay
V
Kumar
Mukesh
M
Lakra
Archana
A
Navkar
Deepa Vishwas
DV
Agarwal
Anil
A
Singh
Ram Badan
RB
Singh
Uttam
U
Singh
Prabhat Kumar
PK
D000293:Adolescent; D000328:Adult; D000758:Anesthesia / Q000009:adverse effects; D018686:Anesthetics, Intravenous / Q000009:adverse effects*; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000627:therapeutic use*; D003371:Cough / Q000139:chemically induced* / Q000188:drug therapy*; D004311:Double-Blind Method; D005260:Female; D005283:Fentanyl / Q000009:adverse effects*; D006801:Humans; D007275:Injections, Intravenous; D008012:Lidocaine / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
D018686:Anesthetics, Intravenous; D000779:Anesthetics, Local; D008012:Lidocaine; D005283:Fentanyl