The frequency of fentanyl-induced cough in children and its effects on tracheal intubation

Abstract 

Study Objective

To determine if fentanyl-induced cough was dose-dependent in children and whether it could affect tracheal intubation.

Design

Prospective, randomized, double-blinded study.

Setting

Operating room of a university-affiliated hospital.

Patients

160 ASA physical status I pediatric patients, aged two to 14 years, scheduled for elective surgery during general anesthesia and requiring orotracheal intubation.

Interventions

Patients were divided into two groups. Group 1 patients were given fentanyl at a dosage of one μg/kg; Group 2 patients received two μg/kg of fentanyl. Induction of anesthesia was conducted immediately following cough cessation or one minute after the end of injection with propofol 2.5 mg/kg. At loss of eyelash reflex, rocuronium 0.6 mg/kg was given intravenously (IV). Two minutes later, tracheal intubation was started.

Measurements

Onset and degree of cough and intubating conditions were observed and recorded.

Main Results

No statistically significant differences in frequency of coughing or in intubating conditions between the two groups were noted. Cough severity in Group 1 was statistically lower than that of Group 2 (P < 0.05). Onset of cough in Group 2 (12.2 ± 3.4 sec) was statistically shorter than in Group 1 (16.9 ± 7.6 sec, P < 0.05).

Conclusion

Fentanyl at doses of one and two μg/kg may induce coughing in pediatric patients.

Keywords: Anesthesia, pediatric, Coughing, Fentanyl, Intubation, intratracheal, Pediatrics