title: The effect of titrated fentanyl on suppressed cough reflex in healthy adult volunteers.
abstract: Cough suppression is part of the pharmacodynamic profile of opioids. We investigated the impact of clinical doses of fentanyl on suppressing the cough reflex. Thirteen volunteers received 2 μg.kg(-1) of fentanyl in a divided administration protocol. Three minutes after each administration and at 10 min intervals during washout, suppressed cough reflex testing with nebulised citric acid was performed and compared with fentanyl effect-site concentration. Mean (SD) citric acid concentration provoking cough increased from 0.5 (0.28) mol.l(-1) at baseline to 1.2 (0.50) mol.l(-1) after 2 μg.kg(-1) of fentanyl (p = 0.01). Mean (SD) fentanyl effect-site concentration after the final dose of fentanyl was 1.89 (0.05) ng.ml(-1) . A strong positive correlation was found between suppressed cough reflex thresholds and fentanyl effect-site concentrations during both fentanyl administration and washout phases of the study (r(2) = 0.79, p = 0.01). The mean (SD) length of time for return of suppressed cough response was 44.6 (18.8) min. Clinically relevant doses of fentanyl produced cough reflex suppression in healthy volunteers.
authors.affiliation: Department of Communication Disorders, University of Canterbury, Christchurch, New Zealand.
authors.forename: H E
authors.initials: HE
authors.lastname: Kelly
authors.affiliation: Christchurch Hospital, Christchurch, New Zealand.
authors.forename: G M
authors.initials: GM
authors.lastname: Shaw
authors.affiliation: Christchurch Hospital, Christchurch, New Zealand.
authors.forename: C N
authors.initials: CN
authors.lastname: Brett
authors.affiliation: Christchurch Hospital, Christchurch, New Zealand.
authors.forename: F M
authors.initials: FM
authors.lastname: Greenwood
authors.affiliation: Rose Centre for Stroke Recovery and Research, University of Canterbury, Christchurch, New Zealand.
authors.forename: M L
authors.initials: ML
authors.lastname: Huckabee
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000494:pharmacology*; D019343:Citric Acid; D003371:Cough / Q000139:chemically induced / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005283:Fentanyl / Q000494:pharmacology*; D064368:Healthy Volunteers; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D012018:Reflex / Q000187:drug effects*; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D019343:Citric Acid; D005283:Fentanyl
keywords: anaesthesia; cough reflex; opioids: fentanyl; pharmacology