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Intravenous lidocaine 0.5 mg·kg-1 effectively suppresses fentanyl-induced cough

L’administration iv de 0,5 mg·kg-1 de lidocaïne supprime efficacement la toux induite par le fentanyl

Canadian Journal of Anesthesia volume 52, pages 172–175 (2005)Cite this article

Abstract

Purpose

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 µg·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, 1 1 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).

Conclusion

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.

Résumé

Objectif

Évaluer la dose minimale de lidocaïne requise pour supprimer la toux induite par le fentanyl. asMéthode

Notre étude comportait 320 patients d’état physique ASA I et II, non-fumeurs des deux sexes, âgés de 18 à 60 ans et répartis en quatre groupes égaux avant une intervention chirurgicale réglée. De la lidocaïne, 0,5 mg·kg-1 (groupe I), 1,0 mg·kg-1 (groupe II), 1,5 mg·kg-1 (groupe III) ou un placebo (groupe IV) ont été administrés pendant cinq secondes, une minute avant 3 µg·kg-1 de fentanyl selon un mode randomisé et à double insu. Les épisodes de toux ont été classifiés et gradués: léger (1–2), modéré (3–4) ou sévère (5 ou plus). Les données ont été analysées par le test de proportion.

Résultats

Onze, 12, 11 et 28 patients (13,75%, 15%, 13,75% et 35 %) des groupes I, II, III et IV ont respectivement eu de la toux (P < 0,05 groupes I, II, III vs IV). Chez les patients prétraités à la lidocaïne, l’incidence et la sévérité de la toux ont été comparables (P > 0,05).

Conclusion

Nos résultats indiquent que l’administration iv de 0,5 mg·kg-1 de lidocaïne est la dose minimale requise pour supprimer la toux induite par le fentanyl quand elle est administrée une minute avant le fentanyl. Toute dose plus élevée ne réduit pas l’incidence ou la sévérité de la toux induite par le fentanyl.

References

  1. Agarwal A, Azim A, Ambesh S, et al. Salbutamol, beclomethasone or sodium chromoglycate suppress coughing induced by iv fentanyl. Can J Anesth 2003; 50: 297–300.

    PubMed  Google Scholar 

  2. Tweed WA, Dakin D. Explosive coughing after bolus fentanyl injection. Anesth Analg 2001; 92: 1442–3.

    PubMed  Article  CAS  Google Scholar 

  3. Bohrer H, Fleischer F, Werning P. Tussive effect of a fentanyl bolus administered through a central venous catheter. Anaesthesia 1990; 45: 18–21.

    PubMed  Article  CAS  Google Scholar 

  4. Phua WT, Teh BT, Jong W, Lee TL, Tweed WA. Tussive effect of a fentanyl bolus. Can J Anaesth 1991; 38: 330–4.

    PubMed  CAS  Google Scholar 

  5. Yukioka H, Yoshimoto N, Nishimura K, Fujimori M. Intravenous lidocaine as a suppressant of coughing during tracheal intubation. Anesth Analg 1985; 64: 1189–92.

    PubMed  Article  CAS  Google Scholar 

  6. Smith FR, Kundahl PC. Intravenously administered lidocaine as cough depressant during general anesthesia for bronchography. Chest 1973, 63: 427–9.

    PubMed  Article  CAS  Google Scholar 

  7. Baraka A. Intravenous lidocaine controls extubation laryngospasm in children. Anesth Analg 1978; 57: 506–7.

    PubMed  Article  CAS  Google Scholar 

  8. Poulton TJ, James FM III. Cough suppression by lidocaine. Anesthesiology 1979; 50: 470–2.

    PubMed  CAS  Article  Google Scholar 

  9. Nishino T, Hiraga K, Sugimori K. Effects of i.v. lignocaine on airway reflexes elicited by irritation of the tracheal mucosa in humans anaesthetized with enflurane. Br J Anaesth 1990; 64: 682–7.

    PubMed  Article  CAS  Google Scholar 

  10. Yukioka H, Hayashi M, Terai T, Fujimori M. Intravenous lidocaine as a suppressant of coughing during tracheal intubation in elderly patients. Anesth Analg 1993; 77: 309–12.

    PubMed  Article  CAS  Google Scholar 

  11. Pandey CK, Raza M, Ranjan R, et al. Intravenous lidocaine suppresses fentanyl-induced coughing: a double-blind, prospective, randomized placebo-controlled study. Anesth Analg 2004; 99: 1696–8.

    PubMed  Article  CAS  Google Scholar 

  12. Lui PW, Hsing CH, Chu YC. Terbutaline inhalation suppresses fentanyl-induced coughing. Can J Anaesth 1996; 43: 1216–9.

    PubMed  CAS  Article  Google Scholar 

  13. Yasuda I, Hirano T, Yusa T, Satoh M. Tracheal constriction by morphine and by fentanyl in man. Anesthesiology 1978: 49: 117–9.

    PubMed  Article  CAS  Google Scholar 

  14. Stellato C, Cirillo R, de Paulis A, et al. Human basophil/mast cell releasability. IX. Heterogeneity of the effects of opioids on mediator release. Anesthesiology 1992; 77: 932–40.

    PubMed  Article  CAS  Google Scholar 

  15. Ricciardolo FL. Mechanisms of citric acid-induced bronchoconstriction. Am J Med 2001; 111: 18S-24S.

    PubMed  Article  Google Scholar 

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Affiliations

  1. From the Departments of Anaesthesiology and Biostatistics, Sanjay Gandhi Postgraduate Institute of Medical Sciences, 226014, Lucknow, India

    Chandra Kant Pandey, Mehdi Raza, Rajeev Ranjan, Vinay Singhal, Mukesh Kumar, Archana Lakra, Deepa Vishwas Navkar, Anil Agarwal, Ram Badan Singh, Uttam Singh & Prabhat Kumar Singh

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  1. Chandra Kant Pandey
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  2. Mehdi Raza
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  3. Rajeev Ranjan
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  4. Vinay Singhal
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  5. Mukesh Kumar
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  6. Archana Lakra
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  7. Deepa Vishwas Navkar
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  8. Anil Agarwal
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  9. Ram Badan Singh
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  10. Uttam Singh
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  11. Prabhat Kumar Singh
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Correspondence to Chandra Kant Pandey.

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Pandey, C.K., Raza, M., Ranjan, R. et al. Intravenous lidocaine 0.5 mg·kg-1 effectively suppresses fentanyl-induced cough. Can J Anaesth 52, 172–175 (2005). https://doi.org/10.1007/BF03027724

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  • DOI: https://doi.org/10.1007/BF03027724

Keywords

  • Fentanyl
  • Lidocaine
  • Terbutaline
  • Intravenous Lidocaine
  • Fentanyl Citrate