Comparison of the Effect of Lidocaine and Ketamine on Prevention of Fentanyl-Induced Cough during the Induction of Anesthesia in Children under General Anesthesia

Document Type : Original Article (s)

Authors

1 Assistant Professor, Department of Anesthesiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Student of Medicine, Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: One of the main adverse effects of fentanyl, as the most commonly used anesthetic drug in children, is coughing. Several medications have been used to reduce this complication. In this study, the effect of ketamine and lidocaine on cough reduction after fentanyl injection was investigated.Methods: This was a randomized clinical trial study on 120 children under general anesthesia aged 6 months to 2 years, with class I and II based on the American Society of Anesthesiologists (ASA) scoring. Patients were divided into 3 equal groups treated with lidocaine (1 mg/kg), ketamine (0.15 mg/kg), and normal saline (control group). The incidence and severity of cough, heart rate, mean arterial pressure, and oxygen saturation were compared between the 3 groups.Findings: The incidence (P = 0.03) and severity (P = 0.03) of cough in control group was significantly higher than two other groups of ketamine and lidocaine.Conclusion: Based on our findings, use of ketamine and/or lidocaine significantly reduces the incidence and severity of coughing following intravenous fentanyl administration under general anesthesia.

Keywords

References

  1. El Baissari MC, Taha SK, Siddik-Sayyid SM. Fentanyl-induced cough--pathophysiology and prevention. Middle East J Anaesthesiol 2014; 22(5): 449-56.
  2. Han JI, Lee H, Kim CH, Lee GY. The frequency of fentanyl-induced cough in children and its effects on tracheal intubation. J Clin Anesth 2010; 22(1): 3-6.
  3. Peringathara B, Robinson S. Fentanyl-induced cough is a risk factor for postoperative nausea and vomiting. Br J Anaesth 2016; 117(2): 269.
  4. Gecaj-Gashi A, Nikolova-Todorova Z, Ismaili-Jaha V, Gashi M. Intravenous lidocaine suppresses fentanyl-induced cough in Children. Cough 2013; 9: 20.
  5. Saleh AJ, Zhang L, Hadi SM, Ouyang W. A priming dose of intravenous ketamine-dexmedetomidine suppresses fentanyl-induced coughing: a double-blind, randomized, controlled study. Ups J Med Sci 2014; 119(4): 333-7.
  6. Golmohammadi M, Shajiee S, Sane S, Valie M. Comparison of the effects of pretreatment ntravenous fentanyl or intravenous lidocaine on suppression of fentanyl-induced cough in children: A randomized, double-blind, controlled clinical trial. Electron Physician 2018; 10(6): 6877-83.
  7. Yeh CC, Wu CT, Huh BK, Lee MS, Lin SL, Sheen J, et al. Premedication with intravenous low-dose ketamine suppresses fentanyl-induced cough. J Clin Anesth 2007; 19(1): 53-6.
  8. Pandey CK, Raza M, Ranjan R, Lakra A, Agarwal A, Singh U, et al. Intravenous lidocaine suppresses fentanyl-induced coughing: A double-blind, prospective, randomized placebo-controlled study. Anesth Analg 2004; 99(6): 1696-8.
  9. Tan W, Li S, Liu X, Gao X, Huang W, Guo J, et al. prophylactic intravenous lidocaine at different doses for fentanyl-induced cough (FIC): A meta-analysis. Sci Rep 2018; 8(1): 9946.
  10. Naldan ME, Arslan Z, Ay A, Yayik AM. Comparison of lidocaine and atropine on fentanyl-induced cough: A randomized controlled study. J Invest Surg 2018.
  11. [Epub ahead of print].
  12. Lin JA, Chen FC, Lee MS, Horng HC, Cherng CH, Yeh CC, et al. Intravenous dexamethasone pretreatment reduces fentanyl-induced cough. J Formos Med Assoc 2007; 106(8): 649-55.
  13. Cheng XY, Lun XQ, Li HB, Zhang ZJ. Butorphanol suppresses fentanyl-induced cough during general anesthesia induction: A randomized, double-blinded, placebo-controlled clinical trial. Medicine (Baltimore) 2016; 95(26): e3911.
  14. Liu HL, An LJ, Su Z, Zhang Y, Gui B. Magnesium sulphate suppresses fentanyl-induced cough during general anesthesia induction: a double-blind, randomized, and placebo-controlled study. Int J Clin Exp Med 2015; 8(7): 11332-6.
  15. Iida K, Handa M, Fukuda K, Saita N, Kasahara M, Koukita Y, et al. Incidence and onset time of fentanyl-induced cough depends on the dose of IV fentanyl. Masui 2009; 58(8): 962-5. [In Japanese].
  16. Liu MQ, Li FX, Han YK, He JY, Shi HW, Liu L, et al. Administration of fentanyl via a slow intravenous fluid line compared with rapid bolus alleviates fentanyl-induced cough during general anesthesia induction. J Zhejiang Univ Sci B 2017; 18(11): 955-62.
  17. Yu H, Yang XY, Zhang X, Li Q, Zhu T, Wang Y, et al. The effect of dilution and prolonged injection time on fentanyl-induced coughing. Anaesthesia 2007; 62(9): 919-22.
  18. Chen YM, Chen WT, Liang SW, Gu MN. Intravenous injection rate and site of fentanyl affect the incidence and onset time of fentanyl-induced cough. Nan Fang Yi Ke Da Xue Xue Bao 2009; 29(2): 339-40. [In Chinese].
  19. 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): 753-8.
Journal of Isfahan Medical School
Volume 37, Issue 516 - Serial Number 516
January and February 2019
Pages 108-113

Files

History

  • Receive Date: 28 October 2018
  • Revise Date: 02 May 2024
  • Accept Date: 06 April 2022

Share

How to cite

Statistics