Abstract:
Background and objectives: The incidence of fentanyl induced cough (FIC) during induction of general anesthesia is around 40% and can be undesirable. This prospective, randomized, dou-ble-blind, placebo-controlled study evaluated the efficacy of dexmedetomidine for the prevention of FIC. Methods: 364 (ASA1 and 2) adult patients undergoing elective surgical procedures under general anesthesia were randomly allocated into four groups. Ten milliliters of dexmedetomidine: 1 mcg/kg (group 1), 0.5 mcg/kg (group 2) and 0.25 mcg/kg (group 3); in addition, ten milliliters of isotonic saline (group 4) were administered intravenously over 10 minutes, to be followed by fentanyl 2mcg/kg intravenously over 5 seconds. The incidence and severity of the cough were recorded for one minute after fentanyl administration. Results: The incidence of FIC was 0%, 5.56%, 10.98%, and 46.15% in groups 1, 2, 3 and 4 respec-tively. Dexmedetomidine in the three doses: 1 mcg/kg, 0.5 mcg/kg and 0.25mcg/kg significantly decreased the incidence of FIC as compared to placebo (p<0.05). There were no cases of severe cough in treatment groups 1 and 2, and no cases of cough in group 1 with no significant hemodynamic differences among the 4 groups. Conclusion: Intravenous dexmedetomidine in doses of 1 mcg/kg, 0.5 mcg/kg, 0.25 mcg/kg, significantly reduced the incidence of fentanyl induced cough. Dexmedetomidine, in the 1 mcg/kg and 0.5 mcg/kg doses, prevented the occurrence of severe cough and dexmedetomidine in a dose of 1 mcg/kg abolished the occurrence of cough. © 2022, American University of Beirut. All rights reserved.
