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Effects of pretreatment with a small dose of dexmedetomidine on sufentanil-induced cough during anesthetic induction

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Abstract

Purpose

We aimed to investigate the effects of pretreatment with a small dose of dexmedetomidine on the cough caused by sufentanil during anesthetic induction.

Methods

Two hundred and forty patients undergoing elective gynecological surgery under general anesthesia were randomly allocated to 4 groups (n = 60, each group). Dexmedetomidine 0, 0.1, 0.25, and 0.5 μg/kg was administered in 5 min to groups I, II, III, and IV, respectively, followed by the induction of general anesthesia with intravenous propofol, at a target concentration of 5 μg/ml, and sufentanil 0.5 μg/kg. The incidences and severity of cough that occurred within 1 min after the injection of sufentanil were recorded, and the incidences of cardiovascular adverse events that occurred between the administration of the dexmedetomidine infusion and 1 min after tracheal intubation were recorded.

Results

The incidences of cough in group II, group III, and group IV were lower than that in group I (6.7, 5.0, and 6.7 vs. 26.7 %, P < 0.01), while there were no significant differences between group II, group III, and group IV. The incidences of severe sinus bradycardia in group III and group IV were higher than that in group I (18.3 and 23.3 vs. 0.0 %, P < 0.01), while there was no significant difference between group I and group II. There was no significant difference in the incidence of low blood pressure among the four groups.

Conclusion

Dexmedetomidine at 0.10, 0.25, and 0.50 μg/kg significantly reduced the incidence of sufentanil-induced cough during anesthetic induction, with the effect being most marked for 0.10 μg/kg dexmedetomidine.

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References

  1. Agarwal A, Aaim A, Ambesh S, Bose N, Dhiraj S, Sahu D, Singh U. Salbutamol, beclomethasone or sodium chromoglycate suppress coughing induced by iv fentanyl. Can J Anaesth. 2003;50(3):297–300.

    Article  PubMed  Google Scholar 

  2. Tweed WA, Dakin D. Explosive coughing after bolus fentanyl injection. Anesth Analg. 2001;92(6):1442–3.

    Article  PubMed  CAS  Google Scholar 

  3. Agarwal A, Gautam S, Nath SS, Gupta D, Singh U. Comparison of the incidence and severity of cough induced by sufentanil and fentanyl: a prospective, randomised, double-blind study. Anaesthesia. 2007;62(12):1230–2.

    Article  PubMed  CAS  Google Scholar 

  4. Lin CS, Sun WZ, Chan WH, Lin CJ, Yeh HM, Mok MS. Intravenous lidocaine and ephedrine, but not propofol, suppress fentanyl-induced cough. Can J Anaesth. 2004;51(7):654–9.

    Article  PubMed  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  6. Pandey CK, Raza M, Ranjan R, Lakra A, Agarwal A, Singh U, Singh RB, Singh PK. Intravenous lidocaine suppresses fentanyl-induced coughing: a double-blind, prospective, randomized placebo-controlled study. Anesth Analg. 2004;99(6):1696–8.

    Article  PubMed  CAS  Google Scholar 

  7. Horng HC, Wong CS, Hsiao KN, Huh BK, Kuo CP, Cherng CH, Wu CT. Pre-medication with intravenous clonidine suppresses fentanyl-induced cough. Acta Anaesthesiol Scand. 2007;51(7):862–5.

    Article  PubMed  CAS  Google Scholar 

  8. Yeh CC, Wu CT, Huh BK, Lee MS, Lin SL, Sheen MJ, Wong CS. Premedication with intravenous low-dose ketamine suppresses fentanyl-induced cough. J Clin Anesth. 2007;19(1):53–6.

    Article  PubMed  CAS  Google Scholar 

  9. Lin JA, Chen FC, Lee MS, Horng HC, Cherng CH, Yeh CC, Wong CS. Intravenous dexamethasone pretreatment reduces fentanyl-induced cough. J Formos Med Assoc. 2007;106(8):649–55.

    Article  PubMed  CAS  Google Scholar 

  10. Hung KC, Chen CW, Lin VC, Weng HC, Hsieh SW. The effect of pre-emptive use of minimal dose fentanyl on fentanyl-induced coughing. Anaesthesia. 2010;65(1):4–7.

    Article  PubMed  CAS  Google Scholar 

  11. Hall JE, Uhrich TD, Barney JA, Arain SR, Ebert TJ. Sedative, amnestic and analgesic properties of small-dose dexmedetomidine infusions. Anesth Analg. 2000;90(3):699–705.

    Article  PubMed  CAS  Google Scholar 

  12. Gharagozlou P, Demirci H, Clark JD, Lameh J. Activation profiles of opioid ligands in HEK cells expressing delta opioid receptors receptors. BMC Neurosci. 2002;3:19.

    Article  PubMed  Google Scholar 

  13. Yemen TA. Small doses of sufentanil will produce violent coughing in young children. Anesthesiology. 1998;89(1):271–2.

    Article  PubMed  CAS  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  15. Tanaka M, Maruyama K. Cough reflex induced by micro-injection of citric acid into the larynx of guinea pigs: new coughing model. J Pharmacol Sci. 2003;93:465–70.

    Article  PubMed  CAS  Google Scholar 

  16. Tanaka M, Maruyama K. Mechanisms of capsaicin and citric acid induced cough reflexes in guinea pigs. J Pharmacol Sci. 2005;99:77–82.

    Article  PubMed  CAS  Google Scholar 

  17. Wang L, Yao JH, Zhu JJ, Liu B, Zhu JG, Zhou DC. Effect of optimizing anesthetic injecting sequence during induction on fentanyl-induced coughing. Chin Med J. 2010;90(13):921–3.

    Google Scholar 

  18. Bhana N, Goa KL, McClellan K. Dexmedetomidine. Drugs. 2000;59(2):263–8.

    Article  PubMed  CAS  Google Scholar 

  19. Weinger MB, Chen DY, Lin T, Lau C, Koob GF, Smith NT. A role for CNS alpha-2 adrenergic receptors in opiate-induced muscle rigidity in the rat. Brain Res. 1995;669(1):10–8.

    Article  PubMed  CAS  Google Scholar 

  20. Hung KC. The possible mechanism of clonidine to suppress fentanyl-induced coughing. Acta Anaesthesiol Scand. 2009;53(9):1227–8.

    Google Scholar 

  21. Groeben H, Mitzner W, Brown RH. Effect of the alpha2-adrenoceptor agonist dexmedetomidine on bronchoconstriction in dogs. Anesthesiology. 2004;100(2):359–63.

    Article  PubMed  CAS  Google Scholar 

  22. Sato T, Hirota K, Matsuki A, Zsigmond EK, Rabito SF. The role of the N-methyl-d-aspartic acid receptor in the relaxant effect of ketamine on tracheal smooth muscle. Anesth Analg. 1998;87(6):1383–8.

    PubMed  CAS  Google Scholar 

  23. Turan G, Ozgultekin A, Turan C, Dincer E, Yuksel G. Advantageous effects of dexmedetomidine on haemodynamic and recovery responses during extubation for intracranial surgery. Eur J Anaesthesiol. 2008;25(10):816–20.

    Article  PubMed  CAS  Google Scholar 

  24. Guler G, Akin A, Tosun Z, Eskitascoqlu E, Mizrak A, Boyaci A. Single-dose dexmedetomidine attenuates airway and circulatory reflexes during extubation. Acta Anaesthesiol Scand. 2005;49(8):1088–91.

    Article  PubMed  CAS  Google Scholar 

  25. Oshima T, Kasuya Y, Okumura Y, Murakami T, Dohi S. Identification of independent risk factors for fentanyl-induced cough. Can J Anaesth. 2006;53(8):753.

    Article  PubMed  Google Scholar 

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Conflict of interest

No external funding and no competing interests are declared.

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Authors and Affiliations

  1. Department of Anesthesiology, The Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China

    Shen Sun & Shao-qiang Huang

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  1. Shen Sun
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  2. Shao-qiang Huang
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Correspondence to Shao-qiang Huang.

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Sun, S., Huang, Sq. Effects of pretreatment with a small dose of dexmedetomidine on sufentanil-induced cough during anesthetic induction. J Anesth 27, 25–28 (2013). https://doi.org/10.1007/s00540-012-1470-y

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  • DOI: https://doi.org/10.1007/s00540-012-1470-y

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