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ANESTHETIC PHARMACOLOGY

Prolonged Injection Time and Light Smoking Decrease the Incidence of Fentanyl-Induced Cough

Department of Anesthesiology, Tri-Service General Hospital and National Defense Medical Center, National Defense University, Taipei, Taiwan, Republic of China

Address correspondence and reprint requests to Chih-Shung Wong, MD, PhD, Department of Anesthesiology, Tri-Service General Hospital and National Defense Medical Center, National Defense University. #325, Section 2, Chenggung Road, Neihu 114, Taipei, Taiwan, Republic of China. Address e-mail to w82556{at}ndmctsgh.edu.tw.

We designed this study to evaluate the effect of injection time and smoking on fentanyl-induced cough. Four-hundred-fifty ASA class I–II patients, aged 18–80 yr and weighing 40–90 kg, scheduled for elective surgery were included. All patients received fentanyl (100 µg for patients weighing 40–69 kg and 150 µg for patients weighing 70–90 kg for clinical convenience) via the proximal port of a peripheral IV line on the forearm. Patients were randomly assigned to 3 groups of 150 patients each. Patients in Group I received fentanyl injection over 2 s, whereas for patients in Groups II and III the fentanyl was injected at a constant rate over 15 s and 30 s, respectively. We recorded the number of coughs of each patient during and 30 s after fentanyl injection. The incidence of cough was 18% in group I, 8% in Group II, and 1.3% in Group III, significantly less (P < 0.05) with a longer injection time. Current smokers had a less frequent incidence of cough than nonsmokers; however, this effect was only significant in light smokers (<10 cigarettes per day or <10 smoking years or <10 pack-years). In conclusion, a longer injection time reduces the incidence of fentanyl-induced cough, and light smoking may be a protective factor against fentanyl-induced cough.