Intravenous dexamethasone pretreatment reduces fentanyl-induced cough.
OBJECTIVE
Fentanyl is regularly used in clinical anesthesia practice but fentanyl-induced cough (FIC) will sometimes bother anesthesiologists. This study was designed to examine the effect of intravenous (IV) dexamethasone (DEX) on FIC.


METHODS
Eighty ASA class I-II patients, aged 18-80 years and weighing 40-90 kg, scheduled for elective surgery were given DEX to reduce FIC. One hundred and eight patients from our previous study database on FIC, after excluding smokers, comprised the reference group. All patients were given fentanyl (100 mug for 40-69 kg and 150 mug for 70-90 kg for clinical convenience) over 2 seconds via the proximal port of a peripheral IV line in the forearm. Patients in the treatment group received DEX (10 mg, IV) 5 minutes prior to fentanyl injection, while those in the reference group received fentanyl injection only without any premedicant. We recorded the number of coughs of each patient for 30 seconds after fentanyl injection.


RESULTS
The incidence of cough was 6.3% in the DEX group and 21.3% in the control group, respectively (p = 0.008). However, the severity of cough observed was not significantly different by DEX pretreatment (p > 0.05) or hemodynamic profiles.


CONCLUSIONS
DEX (10 mg, IV) 5 minutes prior to fentanyl injection reduces the incidence of FIC and can be an ideal premedicant for general anesthesia induction.
Lin
Jui-An
JA
Department of Anesthesiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Chen
Fa-Chang
FC
Lee
Meei-Shyuan
MS
Horng
Huei-Chi
HC
Cherng
Chen-Hwan
CH
Yeh
Chun-Chang
CC
Wong
Chih-Shung
CS
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018686:Anesthetics, Intravenous / Q000009:adverse effects*; D003371:Cough / Q000139:chemically induced / Q000517:prevention & control*; D003907:Dexamethasone / Q000008:administration & dosage*; D005260:Female; D005283:Fentanyl / Q000009:adverse effects*; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged
D018686:Anesthetics, Intravenous; D003907:Dexamethasone; D005283:Fentanyl