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The Effect of Low Dose Lidocaine on Fentanyl-Induced Cough, Mean Arterial Pressure, Heart Rate, Oxygen Saturation and Dizziness in Inhalation Anesthesia

흡입성 전신마취에서 저용량의 리도카인이 펜타닐-유도성 기침, 평균동맥압, 심박동수, 산소포화도 및 어지럼증에 미치는 영향

Lee, Keon Young;Yoon, Haesang
이건영;윤혜상

  • Received : 2012.11.06
  • Accepted : 2012.12.11
  • Published : 2012.12.31

Abstract

Purpose: This study was performed to evaluate the effect of low-dose lidocaine on fentanyl-induced cough and hemodynamic changes under general anesthesia. This research was a randomized trial design and performed using a double-blind method. Methods: Data collection was performed from October 22, 2008, to May 4, 2009. One hundred and thirty two patients were randomly assigned to control group (Con G) and experimental group (Exp G) using a table of random numbers. Exp G (n=66) were administered 0.5 mg/kg lidocaine and Con G (n=66)) were administered saline. The occurrence of cough and vital sign were recorded within one minute after fentanyl bolus by an anesthesiologist. Collected data were analyzed using Repeated measures ANOVA using SPSS for Windows (Version 17.0). Results: The incidence of cough in Exp G was 13.6%, while Con G was 53%. The incidence cough in Exp G was significantly lower compared to Con G (p<.001). Lidocaine seemed not to suppress mean arterial pressure (p=.145), heart rate (p=.508), and oxygen saturation (p=.161). Conclusion: Intravenous administration of 0.5 mg/kg lidocaine seems to suppress fentanyl-induced cough without affecting mean blood pressure, heart rate and oxygen saturation. Therefore, we recommend intravenous 0.5 mg/kg lidocaine administration to suppress fentanyl-induced cough under general anesthesia.

Keywords

Cough;Fentanyl;Intra-operative care;Lidocaine

References

  1. Addington, W. R., Stephens, R. E., Phelipa, M. M., Widdicombe, Y. G., & Ockey, R. R. (2008). Intra-abdominal pressures during voluntary & reflexs cough. Cough, 4, 1-9. https://doi.org/10.1186/1745-9974-4-1
  2. Agarwal, A., Gautam, S., Nath, S. S., Gupta, D., & Shigh, U. (2007). Comparison of the incidence and severity of cough induced by sufentanil and fentanyl: A prospective, randomized, double-blind study. Anaesthesia, 62, 1230-1232. https://doi.org/10.1111/j.1365-2044.2007.05249.x
  3. Bohrer, H., Fleischer, F., & Werning, P. (1990). Tussive effect of a fentanyl bolus administered through a central venous catheter. Anaesthesia, 45, 18-21. https://doi.org/10.1111/j.1365-2044.1990.tb14496.x
  4. Brevisi, M. G. (2008). Preclinical assessment of novel therapeutics on the cough reflex: Cannabinoid agonists as potentail antitussives. Lung, 186, 66-69. https://doi.org/10.1007/s00408-007-9028-8
  5. Chang, H. Y., Togias, A., & Brown, R. H. (2007). The effects of systemic lidocaine on airway tone and pulmonary function in asthmatic subjects. Anesthesia and Analgesia, 104, 1109-1115. https://doi.org/10.1213/01.ane.0000260638.57139.87
  6. Edwards, N. D., Alford, A. M., Dobson, P. M., Peacock, J. E., & Reilly, C. S. (1994). Myocardial ischaemia during tracheal intubation and extubation. British Journal of Anaesthesia, 73, 537-539. https://doi.org/10.1093/bja/73.4.537
  7. Forestner, J. E. (2010). Frank J. Murphy, M.D., C.M., 1900-1972: his life, career, and the Murphy eye. Anesthesiology, 113, 1019-1025. https://doi.org/10.1097/ALN.0b013e3181f55e7a
  8. Generali, J., & Cada, D. J. (2007). Lidocaine: Cough (fentanyl induced). Hospital Pharmacy, 42, 617-625. https://doi.org/10.1310/hpj4207-617
  9. Groeben, H., Silvanus, M. T., Beste, M., & Peters, J. (1998). Combined intravenous lidocaine and inhaled salbutamol protect against bronchial hyperreactivity more effectively than lidocaine or salbutamol alone. Anesthesiology, 89, 862-868. https://doi.org/10.1097/00000542-199810000-00010
  10. Hanak, V., Hartman, T. E., & Ryu, J. H. (2005). Cough-induced rib fractures. Mayo Clinic Proceedings, 80, 879-882. https://doi.org/10.4065/80.7.879
  11. Hirota, K., Hashimoto, Y., Sato, T., Yoshioka, H., Kudo, T., Ishihara, H., et al. (1999). I.V. lidocaine worsens histamine-induced bronchoconstriction in dogs. British Journal of Anaesthesia, 82, 87-89. https://doi.org/10.1093/bja/82.1.87
  12. Hong, J. Y., Kim, W. O., Kil, H. K., Kim, C. H., & Lee, S. L. (1997). Dose response of fentanyl cough reflex through peripheral venous catheter. Korean Journal of Anesthesiology, 33, 59-62. https://doi.org/10.4097/kjae.1997.33.1.59
  13. Hwang, J. H., Kim, Y. H., Lee, J. H., Jung, Y. S., Go, Y. K., Yoon, M. J., & et al. (2008). Comparison of effects of fentanyl, alfentanil and remifentanil on the cardiovasuclar response to endotracheal intubation during the induction of general anesthesia. Korean Journal of Anesthesiology, 54, 18-24. https://doi.org/10.4097/kjae.2008.54.1.18
  14. Kaplan, J. D., & Schuster, D. P. (1991). Physiologic consequences of tracheal intubation. Clinics in Chest Medicine, 12, 425-432.
  15. Kim, E. J., & Yoon, H. (2012). Influence of midazolam and glycopyrrolate on intra-operative body temperature in abdominal surgical patients. Journal of Korean Biological Nursing Science, 14, 25-32. https://doi.org/10.7586/jkbns.2012.14.1.25
  16. Kim, J. Y., Park, K. S., Kim, J. S., Park, S. Y., & Kim, J. W. (2008). The effect of lidocaine on remifentanil-induced cough. Korean Journal of Anesthesiology, 63, 495-498.
  17. Kim, S. T,, Hwang, J. W., Lee, K. H., Kang, J. H., Baek, H. M., & Oh, Y. S. (1998). Changes of plasma lidocaine concentration with intravenous injection in general anesthesia, Korean Journal of Anesthesiology, 34, 537-542. https://doi.org/10.4097/kjae.1998.34.3.537
  18. Leone, M., Albanese, J., Viviand, X., Garnier, F., Bourgoin, A., Barrau, K., et al. (2004). The effects of remifentanil on endotracheal suctioning-induced increases in intracranial pressure in head-injured patients. Anesthesia and Analgesia, 99, 1193-1198. https://doi.org/10.1213/01.ANE.0000132546.79769.91
  19. Lim, J. H., Ryu, S. J., & Lim, Y. S. (2010). The incidence of cough induced by remifentanil during anesthetic induction was decreased by graded escalation of the remifentanil concentration. Korean Journal of Anesthesiology, 58, 117-121. https://doi.org/10.4097/kjae.2010.58.2.117
  20. Lin, C. S., Sun, W. Z., Chan, W. H., Lin, C J., Yeh, H. M., & Mok, M. S. (2004). Intravenous lidocaine and ephedrine, but not propofol, suppress fentanyl-induced cough. Canadian Journal of Anaesthesia, 51, 654-659. https://doi.org/10.1007/BF03018421
  21. Lin, J. A., Yeh, C. C., Lee, M. S., Wu, C. T., Lin, S. L., & Wong, C. S. (2005). Prolonged injection time and light smoking decrease the incidence of fentanyl-induced cough. Anesthesia and Analgesia, 101, 670-674. https://doi.org/10.1213/01.ANE.0000159161.31276.DB
  22. Muraki, M., Iwanaga, T., Haraguchi, R., Kubo, H., & Tohda, Y. (2008). Continued inhalation of lidocaine suppresses antigen-induced airway hyperreactivity and airway inflammation in ovalbumin-sensitized guinea pigs. Immunopharmacology, 8, 725-731. https://doi.org/10.1016/j.intimp.2008.01.021
  23. Oshima, T., Kasuya, Y., Okumura, Y., Marukami, T., & Dohi, S. (2006). Identification of independent risk factors for fentanyl-induced cough. Canadian Journal of Anaesthesia, 53, 753-758. https://doi.org/10.1007/BF03022790
  24. Pandey, C. K., Raza, M., Ranjan, R., Lakra, A., Agarwal, A., Singh, U., et al. (2004). Intravenous lidocaine suppresses fentanyl-induced coughing: A double-blind, prospective, randomized placebo-controlled study. Anesthesia and Analgesia, 99, 1696-1698.
  25. Pandey, C. K., Raza, M., Ranjan, R., Singhal, V., Kumar, M., Lakra, A., et al. (2005). Intravenous lidocaine 0.5 mg.kg-1 effectively suppresses fentanyl-induced cough. Canadian Journal of Anaesthesia, 52, 172-175. https://doi.org/10.1007/BF03027724
  26. Samake, B. M., Goita, O., Goita, D., Diallo, A., & Coulibaly, Y. (2011). Lidocaine interest in endotracheal intubation. Le Mali Medical, 26, 22-24.
  27. Schappermeier, U., & Hopf, H. B. (2008). Fentanyl-induced cough does not depend on injection speed: a randomized study. Acta Anaesthesiologica Scandinavica, 52, 1071-1075. https://doi.org/10.1111/j.1399-6576.2008.01721.x
  28. Schlimp, C. J., & Wiedermann, F. J. (2005). Does fentanyl-induced cough justify pre-treatment with iv lidocaine 2 mg.kg-1. Canadian Journal of Anaesthesia, 52, 207.
  29. Tweed, W. A., & Dakin, D. (2001). Explosive coughing after bolus fentanyl injection. Anesthesia and Analgesia, 92, 1442-1443.
  30. Yu, H., Yang, X. Y., Zhang, X., Li, Q., Zhu, T., Wang, Y., et al. (2007). The effect of dilution and prolonged injection time on fentanyl-induced coughing. Anaesthesia, 62, 919-922. https://doi.org/10.1111/j.1365-2044.2007.05147.x
  31. Yukioka, H., Hayashi, M., Terai, T., & Fujimori, M. (1993). IV lidocaine as a suppressant of coughing during tracheal intubation in elderly patients. Anesthesia and Analgesia, 77, 309-312. https://doi.org/10.1213/00000539-199308000-00016

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  1. Prophylactic Intravenous Lidocaine at Different Doses for Fentanyl-Induced Cough (FIC): A Meta-Analysis vol.8, pp.1, 2018, https://doi.org/10.1038/s41598-018-27457-3