title: [The effect of pheniramine on fentanyl-induced cough: a randomized, double blinded, placebo controlled clinical study].
abstract: OBJECTIVE
  There are many studies conducted on reducing the frequency and severity of fentayl-induced cough during anesthesia induction. We propose that pheniramine maleate, an antihistaminic, may suppress this cough. We aim to observe the effect of pheniramine on fentanyl-induced cough during anesthesia induction.
  
  
  METHODS
  This is a double-blinded, prospective, three-arm parallel, randomized clinical trial of 120 patients with ASA (American Society of Anesthesiologists) physical status III and IV who aged ≥18 and scheduled for elective open heart surgery during general anesthesia. Patients were randomly assigned to three groups of 40 patients, using computer-generated random numbers: placebo group, pheniramine group, and lidocaine group.
  
  
  RESULTS
  Cough incidence differed significantly between groups. In the placebo group, 37.5% of patients had cough, whereas the frequency was significantly decreased in pheniramine group (5%) and lidocaine group (15%) (Fischer exact test, p=0.0007 and p=0.0188, respectively). There was no significant change in cough incidence between pheniramine group (5%) and lidocaine group (15%) (Fischer exact test, p=0.4325). Cough severity did also change between groups. Post Hoc tests with Bonferroni showed that mean cough severity in placebo differed significantly than that of pheniramine group and lidocaine group (p<0.0001 and p=0.009, respectively). There was no significant change in cough severity between pheniramine group and lidocaine group (p=0.856).
  
  
  CONCLUSIONS
  Intravenous pheniramine is as effective as lidocaine in preventing fentayl-induced cough. Our results emphasize that pheniramine is a convenient drug to decrease this cough.
authors.affiliation: Regional Training and Research Hospital, Departamento de Anestesiologia e Tratamento Intensivo, Erzurum, Turquia. Electronic address: zakir-arslan@hotmail.com.
authors.forename: Zakir
authors.initials: Z
authors.lastname: Arslan
authors.affiliation: Regional Training and Research Hospital, Departamento de Cirurgia Cardíaca, Erzurum, Turquia.
authors.forename: Eyup Serhat
authors.initials: ES
authors.lastname: Çalık
authors.affiliation: Regional Training and Research Hospital, Departamento de Anestesiologia e Tratamento Intensivo, Erzurum, Turquia.
authors.forename: Bekir
authors.initials: B
authors.lastname: Kaplan
authors.affiliation: Regional Training and Research Hospital, Departamento de Anestesiologia e Tratamento Intensivo, Erzurum, Turquia.
authors.forename: Elif Oral
authors.initials: EO
authors.lastname: Ahiskalioglu
keywords: Anesthesia; Cough; Fentanil; Fentanyl; Maleato de feniramina; Pheniramine maleat; Tosse