Swallowing action immediately before intravenous fentanyl at induction of anesthesia prevents fentanyl-induced coughing

a randomized controlled study

Saori Sako, Shoji Tokunaga, Masanori Tsukamoto, Jun Yoshino, Naoyuki Fujimura, Takeshi Yokoyama

研究成果: ジャーナルへの寄稿記事

2 引用 (Scopus)

抄録

Purpose: Fentanyl is a strong µ-opioid analgesic which attenuates the stimulation of surgical invasion and tracheal intubation. However, intravenous fentanyl often induces coughing [fentanyl-induced coughing (FIC)] during induction of anesthesia. We found that the swallowing action, when requested at induction of anesthesia, attenuated FIC. In the current study, we investigated the relationship between the occurrence of FIC and the swallowing action. Methods: The study included American Society of Anesthesiologists physical status I or II patients, aged 20–64 years, who were undergoing elective surgery. They were divided into two groups—one group was urged to perform the swallowing action immediately before intravenous fentanyl (S group), and the other group performed no swallowing action (non-S group). The patients first received intravenous fentanyl and were observed for 90 s. Each patient’s background, dose of fentanyl and occurrence of coughing were investigated from their records and a motion picture recording. The incidence of FIC was evaluated by chi-squared test, and severity was tested by Wilcoxon rank-sum test. P < 0.05 was considered statistically significant. Results: The incidence of FIC in the S group and non-S group was 14.0 and 40.4%, respectively. The risk of FIC was reduced in the S group by 75%; risk ratio (95% confidence interval) was 0.35 (0.20, 0.60). The number of coughs in the S group were less than in the non-S group (P < 0.001). Conclusion: The swallowing action immediately before intravenous fentanyl may be a simple and clinically feasible method for preventing FIC effectively. Clinical trial number: UMIN000012086 (https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr.cgi?function=brows&action=brows&type=summary&recptno=Rn000014126&language=J).

元の言語英語
ページ(範囲)212-218
ページ数7
ジャーナルJournal of Anesthesia
31
発行部数2
DOI
出版物ステータス出版済み - 4 1 2017

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Fentanyl
Deglutition
Anesthesia
Nonparametric Statistics
Incidence
Motion Pictures
Cough
Intubation
Opioid Analgesics
Language
Odds Ratio
Clinical Trials
Confidence Intervals

All Science Journal Classification (ASJC) codes

  • Anesthesiology and Pain Medicine

これを引用

Swallowing action immediately before intravenous fentanyl at induction of anesthesia prevents fentanyl-induced coughing : a randomized controlled study. / Sako, Saori; Tokunaga, Shoji; Tsukamoto, Masanori; Yoshino, Jun; Fujimura, Naoyuki; Yokoyama, Takeshi.

:: Journal of Anesthesia, 巻 31, 番号 2, 01.04.2017, p. 212-218.

研究成果: ジャーナルへの寄稿記事

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abstract = "Purpose: Fentanyl is a strong µ-opioid analgesic which attenuates the stimulation of surgical invasion and tracheal intubation. However, intravenous fentanyl often induces coughing [fentanyl-induced coughing (FIC)] during induction of anesthesia. We found that the swallowing action, when requested at induction of anesthesia, attenuated FIC. In the current study, we investigated the relationship between the occurrence of FIC and the swallowing action. Methods: The study included American Society of Anesthesiologists physical status I or II patients, aged 20–64 years, who were undergoing elective surgery. They were divided into two groups—one group was urged to perform the swallowing action immediately before intravenous fentanyl (S group), and the other group performed no swallowing action (non-S group). The patients first received intravenous fentanyl and were observed for 90 s. Each patient’s background, dose of fentanyl and occurrence of coughing were investigated from their records and a motion picture recording. The incidence of FIC was evaluated by chi-squared test, and severity was tested by Wilcoxon rank-sum test. P < 0.05 was considered statistically significant. Results: The incidence of FIC in the S group and non-S group was 14.0 and 40.4{\%}, respectively. The risk of FIC was reduced in the S group by 75{\%}; risk ratio (95{\%} confidence interval) was 0.35 (0.20, 0.60). The number of coughs in the S group were less than in the non-S group (P < 0.001). Conclusion: The swallowing action immediately before intravenous fentanyl may be a simple and clinically feasible method for preventing FIC effectively. Clinical trial number: UMIN000012086 (https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr.cgi?function=brows&action=brows&type=summary&recptno=Rn000014126&language=J).",
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T2 - a randomized controlled study

AU - Sako, Saori

AU - Tokunaga, Shoji

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AU - Yoshino, Jun

AU - Fujimura, Naoyuki

AU - Yokoyama, Takeshi

PY - 2017/4/1

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AB - Purpose: Fentanyl is a strong µ-opioid analgesic which attenuates the stimulation of surgical invasion and tracheal intubation. However, intravenous fentanyl often induces coughing [fentanyl-induced coughing (FIC)] during induction of anesthesia. We found that the swallowing action, when requested at induction of anesthesia, attenuated FIC. In the current study, we investigated the relationship between the occurrence of FIC and the swallowing action. Methods: The study included American Society of Anesthesiologists physical status I or II patients, aged 20–64 years, who were undergoing elective surgery. They were divided into two groups—one group was urged to perform the swallowing action immediately before intravenous fentanyl (S group), and the other group performed no swallowing action (non-S group). The patients first received intravenous fentanyl and were observed for 90 s. Each patient’s background, dose of fentanyl and occurrence of coughing were investigated from their records and a motion picture recording. The incidence of FIC was evaluated by chi-squared test, and severity was tested by Wilcoxon rank-sum test. P < 0.05 was considered statistically significant. Results: The incidence of FIC in the S group and non-S group was 14.0 and 40.4%, respectively. The risk of FIC was reduced in the S group by 75%; risk ratio (95% confidence interval) was 0.35 (0.20, 0.60). The number of coughs in the S group were less than in the non-S group (P < 0.001). Conclusion: The swallowing action immediately before intravenous fentanyl may be a simple and clinically feasible method for preventing FIC effectively. Clinical trial number: UMIN000012086 (https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr.cgi?function=brows&action=brows&type=summary&recptno=Rn000014126&language=J).

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