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.
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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