Abstract
Purpose
The aim of this study was to evaluate the effectiveness of lidocaine, propofol and ephedrine in suppressing fentanyl-induced cough.
Methods
One hundred and eighteen patients were randomly assigned into four groups and the following medications were given intravenously: patients in Group I (n = 31) received normal saline 2 mL, Group II (n = 29) received lidocaine 2 mg · kg−1, Group III (n = 30) received propofol 0.6 mg · kg−1 and Group IV (n = 28) received ephedrine 5 mg. At one minute after the study medication, fentanyl 2.5 μg · kg−1 was given intravenously within two seconds. The occurrence of cough and vital sign profiles were recorded within two minutes after fentanyl bolus by an anesthesiologist blinded to study design.
Results
Sixty-five percent of patients in the placebo group had cough, whereas the frequency was significantly decreased in Groups II(14%) and IV (21%). Although a numerically lower frequency of cough was noted in Group III (37%), it was not statistically different from that of the placebo group. SpO2 decreased significantly in patients of Group III compared to placebo; one patient experienced hypoxemia necessitating mask ventilation. Patients in Group III showed a decrease in heart rate and systolic blood pressure (2 beats · min−1 and 8 mmHg vs baseline). Patients in Group IV showed an increase in both measurements (5 beats · min−1 and 8 mmHg vs baseline). No truncal rigidity was observed throughout the study.
Conclusions
Intravenous lidocaine 2 mg · kg−1 or ephedrine 5 mg, but not propofol 0.6 mg · kg−1, was effective in preventing fentanyl-induced cough. The results provide a convenient method to decrease fentanyl-induced cough.
Résumé
Objectif
Évaluer l’efficacité de la lidocaïne, du propofol et de l’éphédrine dans la suppression de la toux induite par le fentanyl.
Méthode
Cent dix-huit patients ont été répartis au hasard en quatre groupes et ont reçu: Groupe l (n = 31), 2 mL de solution saline; Groupe II (n = 29), 2mg · kg−1de lidocaïne; Groupe III (n = 30), 0,6 mg · kg−1 de propofol et Groupe IV (n = 28), 5 mg d’éphédrine. À une minute après la médication expérimentale, 2,5 μg · kg−1 de fentanyl iv ont été administrés en moins de deux secondes. L’occurrence de toux et les profils des signes vitaux ont été enregistrés par un anesthésiologiste impartial pendant les deux minutes qui ont suivi l’administration de bolus de fentanyl.
Résultats
Soixante-cinq pour cent des patients du groupe placebo ont eu de la toux, tandis que la fréquence a significativement diminué dans les Groupes II (14 %) et IV (21 %). Même si une fréquence de toux numériquement plus basse a été notée dans le Groupe III, elle n’était pas statistiquement différente de celle du groupe placebo. La SpO2 a diminué significativement chez les patients du Groupe III comparé au groupe placebo; un patient a présenté de l’hypoxémie nécessitant une ventilation au masque. Les patients du Groupe III ont subi une baisse de la fréquence cardiaque et de la tension artérielle systolique (2 battements · min−1 et 8 mmHg vs les mesures de base). Ceux du Groupe IV ont présenté une augmentation de ces deux paramètres (5 battements · min−1 et 8 mmHg vs les mesures de base). Aucune rigidité tronculaire n’a été observée pendant l’étude.
Conclusion
L’administration iv de 2 mg · kg−1 de lidocaïne ou de 5 mg d’éphédrine, mais non de 0,6 mg · kg−1 de propofol, a été efficace pour prévenir la toux induite par le fentanyl. Les résultats offrent une méthode pratique de diminuer la toux induite par le fentanyl.
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Lin, C.S., Sun, W.Z., Chan, W.H. et al. Intravenous lidocaine and ephedrine, but not propofol, suppress fentanyl-induced cough. Can J Anesth 51, 654–659 (2004). https://doi.org/10.1007/BF03018421
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DOI: https://doi.org/10.1007/BF03018421