PMID- 24688150
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20140401
LR  - 20211021
IS  - 0011-393X (Print)
IS  - 0011-393X (Linking)
VI  - 71
IP  - 5
DP  - 2010 Oct
TI  - Comparison of the effects of ketamine or lidocaine on fentanyl-induced cough in 
      patients undergoing surgery: A prospective, double-blind, randomized, 
      placebo-controlled study.
PG  - 289-97
LID - 10.1016/j.curtheres.2010.10.004 [doi]
AB  - BACKGROUND: Fentanyl-induced cough is common but has not been viewed as a serious 
      anesthetic problem. However, the cough may be explosive at times, may require 
      immediate intervention, and may be associated with undesirable increases in 
      intracranial, intraocular, and intra-abdominal pressures. Prevention of 
      fentanylinduced cough in such situations is of paramount importance. Ketamine, at 
      concentrations achieved with standard clinical doses, has a direct relaxant 
      effect on airway smooth muscle. OBJECTIVE: This study was designed to assess the 
      effects of ketamine or lidocaine on fentanyl-induced cough. METHODS: This 
      double-blind, randomized, placebo-controlled study was conducted at the Erciyes 
      University Medical School, Kayseri, Turkey. Consecutive adult patients aged 18 to 
      65 years and classified as American Society of Anesthesiologists physical status 
      I or II who were undergoing elective surgery with general anesthesia were 
      enrolled. Patients were randomly allocated equally into 3 groups to receive 
      lidocaine 1 mg/kg, ketamine 0.5 mug/kg, or placebo intravenously 1 minute before 
      fentanyl administration. Following intravenous fentanyl (1.5 mug/kg over 2 
      seconds) injection, an observer, unaware of the type of medication given to the 
      patients, recorded the number of episodes of coughing, if any. Any episode of 
      cough was classified as coughing and graded by investigators blinded to treatment 
      as mild (1-2 coughs), moderate (3-4), or severe (>/=5). Blood pressure, heart rate, 
      pulse oximetry oxygen saturation (SpO2), and adverse effects (AEs) were recorded. 
      RESULTS: A total of 368 patients were approached for inclusion; 300 patients met 
      the inclusion criteria and were enrolled in the study. No patients in the 
      ketamine group had cough. The frequency of cough was significantly lower in the 
      lidocaine (11/100 [11%]; P = 0.024) and ketamine (0/100; P = 0.001) groups 
      compared with the placebo group (23/100 [23%]). The intensity of cough was 
      significantly lower in the lidocaine (mild, 7/100 [7%]; moderate, 4/100 [4%]; P = 
      0.037) and ketamine (0/100; P < 0.001) groups compared with the placebo group 
      (mild, 10/100 [10%]; moderate, 12/100 [12%]; severe, 1/100 [1%]). Severe cough 
      (>/=5) was observed in 1 patient in the placebo group. Incidence and intensity of 
      cough were significantly decreased in the ketamine group compared with the 
      lidocaine group (incidence, P = 0.001; intensity, P = 0.003). There were no 
      significant differences between groups with respect to systolic blood pressure, 
      diastolic blood pressure, heart rate, SpO2, and AEs. CONCLUSION: Intravenous 
      ketamine (0.5 mg/kg) significantly reduced the reflex cough induced by fentanyl 
      compared with lidocaine and placebo, and was well tolerated.
FAU - Guler, Gulen
AU  - Guler G
AD  - Medical Faculty, Department of Anesthesiology, Erciyes University, Kayseri, 
      Turkey.
FAU - Aksu, Recep
AU  - Aksu R
AD  - Medical Faculty, Department of Anesthesiology, Erciyes University, Kayseri, 
      Turkey.
FAU - Bicer, Cihangir
AU  - Bicer C
AD  - Medical Faculty, Department of Anesthesiology, Erciyes University, Kayseri, 
      Turkey.
FAU - Tosun, Zeynep
AU  - Tosun Z
AD  - Medical Faculty, Department of Anesthesiology, Erciyes University, Kayseri, 
      Turkey.
FAU - Boyaci, Adem
AU  - Boyaci A
AD  - Medical Faculty, Department of Anesthesiology, Erciyes University, Kayseri, 
      Turkey.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Curr Ther Res Clin Exp
JT  - Current therapeutic research, clinical and experimental
JID - 0372621
PMC - PMC3969624
OTO - NOTNLM
OT  - coughing
OT  - fentanyl
OT  - ketamine
OT  - lidocaine
EDAT- 2010/10/01 00:00
MHDA- 2010/10/01 00:01
PMCR- 2010/10/01
CRDT- 2014/04/02 06:00
PHST- 2010/08/17 00:00 [accepted]
PHST- 2014/04/02 06:00 [entrez]
PHST- 2010/10/01 00:00 [pubmed]
PHST- 2010/10/01 00:01 [medline]
PHST- 2010/10/01 00:00 [pmc-release]
AID - S0011-393X(10)00080-9 [pii]
AID - 10.1016/j.curtheres.2010.10.004 [doi]
PST - ppublish
SO  - Curr Ther Res Clin Exp. 2010 Oct;71(5):289-97. doi: 
      10.1016/j.curtheres.2010.10.004.