title: Pharmacological and nonpharmacological prevention   of fentanyl-induced cough: a meta-analysis.
abstract: Fentanyl-induced cough (FIC) is often observed after intravenous bolus administration of fentanyl during anesthesia induction. This meta-analysis assessed the efficacy of pharmacological and nonpharmacological interventions to reduce the incidence of FIC. We searched for randomized controlled trials comparing pharmacological or nonpharmacological interventions with controls to prevent FIC; we included 28 studies retrieved from Pub-Med, Embase, and Cochrane Library. Overall incidence of FIC was approximately 31 %. Lidocaine [odds ratio (OR) = 0.29, 95 % confidence interval (CI) 0.21–0.39], N-methyl-D-aspartate (NMDA) receptor antagonists (OR 0.09, 95 % CI 0.02–0.42), propofol (OR 0.07, 95 % CI 0.01–0.36), a2 agonists (OR 0.32, 95 % CI 0.21–0.48), b2 agonists (OR 0.10, 95 % CI 0.03–0.30), fentanyl priming (OR 0.33, 95 % CI 0.19–0.56), and slow injection of fentanyl (OR 0.25, 95 % CI 0.11–0.58)] were effective in decreasing the incidence of FIC, whereas atropine (OR 1.10, 95 % CI 0.58–2.11) and benzodiazepines (OR 2.04, 95 % CI 1.33–3.13) were not effective. This meta-analysis found that lidocaine, NMDA receptor antagonists, propofol, a2 agonists, b2 agonists, and priming dose of fentanyl were effective in preventing FIC, but atropine and benzodiazepines were not. Slow injection of fentanyl was effective in preventing FIC, but results depend on the speed of administration.
authors: Ji Eun
authors: JE
authors: Kim
authors: Sang Kee
authors: SK
authors: Min
authors: Yun Jeong
authors: YJ
authors: Chae
authors: Yeon Ju
authors: YJ
authors: Lee
authors: Bong Ki
authors: BK
authors: Moon
authors: Jong Yeop
authors: JY
authors: Kim
mesh_terms: D061605:Administration, Intravenous; D000322:Adrenergic Agonists / Q000627:therapeutic use; D000328:Adult; D018686:Anesthetics, Intravenous / Q000008:administration & dosage / Q000009:adverse effects*; D000779:Anesthetics, Local / Q000627:therapeutic use; D003371:Cough / Q000139:chemically induced* / Q000209:etiology / Q000517:prevention & control*; D005283:Fentanyl / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D008012:Lidocaine / Q000627:therapeutic use; D015742:Propofol / Q000627:therapeutic use; D016194:Receptors, N-Methyl-D-Aspartate / Q000037:antagonists & inhibitors
chemical_list: D000322:Adrenergic Agonists; D018686:Anesthetics, Intravenous; D000779:Anesthetics, Local; D016194:Receptors, N-Methyl-D-Aspartate; D008012:Lidocaine; D005283:Fentanyl; D015742:Propofol
references: J Int Med Res. 2011;39(6):2379-84
references: 22289557
references: Br J Anaesth. 2010 Jan;104(1):40-3
references: 19933512
references: Can J Anaesth. 2005 Feb;52(2):172-5
references: 15684258
references: Anesth Analg. 2005 Sep;101(3):670-674
references: 16115973
references: Anaesthesia. 2007 Sep;62(9):919-22
references: 17697219
references: Cough. 2013 Feb 01;9(1):3
references: 23369146
references: Pharmacol Rep. 2012;64(2):321-5
references: 22661182
references: Kathmandu Univ Med J (KUMJ). 2012 Oct-Dec;10(40):16-9
references: 23575046
references: Acta Anaesthesiol Scand. 2008 Sep;52(8):1071-5
references: 18840106
references: Pharmacol Rep. 2010 Jul-Aug;62(4):747-50
references: 20885016
references: Can J Anaesth. 2005 Feb;52(2):207
references: 15684266
references: Middle East J Anaesthesiol. 2006 Jun;18(5):943-6
references: 17094533
references: Anaesthesia. 2010 Jan;65(1):4-7
references: 19889113
references: Phys Ther. 2009 Sep;89(9):873-80
references: 19723669
references: Ups J Med Sci. 2010 May;115(2):121-4
references: 19824805
references: Can J Anaesth. 2003 Mar;50(3):297-300
references: 12620955
references: Acta Anaesthesiol Scand. 2009 Oct;53(9):1227-8
references: 19737186
references: Curr Ther Res Clin Exp. 2010 Oct;71(5):289-97
references: 24688150
references: Acta Anaesthesiol Scand. 2007 Aug;51(7):862-5
references: 17578464
references: Can J Anaesth. 1991 Apr;38(3):330-4
references: 2036693
references: Acta Anaesthesiol Taiwan. 2012 Dec;50(4):147-9
references: 23385035
references: J Clin Epidemiol. 2000 Feb;53(2):207-16
references: 10729693
references: Anesthesiology. 1978 Aug;49(2):117-9
references: 686415
references: J Clin Anesth. 2007 Feb;19(1):53-6
references: 17321928
references: Can J Anaesth. 1996 Dec;43(12):1216-9
references: 8955969
references: Anaesthesia. 1990 Jan;45(1):18-21
references: 2316832
references: Ups J Med Sci. 2012 Mar;117(1):18-21
references: 22335390
references: Korean J Anesthesiol. 2012 Jul;63(1):30-5
references: 22870362
references: Anesth Analg. 2004 Dec;99(6):1696-1698
references: 15562056
references: Anesthesiology. 1979 May;50(5):470-2
references: 453567
references: Anesth Analg. 1996 Jul;83(1):162-8
references: 8659728
references: J Anaesthesiol Clin Pharmacol. 2011 Oct;27(4):489-94
references: 22096282
references: Nan Fang Yi Ke Da Xue Xue Bao. 2009 Feb;29(2):339-40
references: 19246317
references: Anesth Analg. 2001 Jun;92(6):1442-3
references: 11375822
references: Ir J Med Sci. 2012 Dec;181(4):517-20
references: 22373589
references: Can J Anaesth. 2004 Aug-Sep;51(7):654-9
references: 15310631
references: J Anesth. 2011 Dec;25(6):860-3
references: 21935685
references: J Clin Epidemiol. 2005 Sep;58(9):894-901
references: 16085192