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Fentanyl-induced cough--pathophysiology and prevention
Middle East Journal of Anaesthesiology
|August 21, 2014
Summary
Fentanyl administration during anesthesia can induce coughing, potentially causing dangerous pressure increases. Factors like patient characteristics and fentanyl administration methods influence this side effect, but preventive measures exist.
Area of Science:
- Anesthesiology
- Pharmacology
Background:
- Intravenous fentanyl bolus administration at anesthesia induction is frequently associated with coughing.
- This fentanyl-induced cough can lead to adverse effects such as increased intraabdominal, intracranial, or intraocular pressure.
Purpose of the Study:
- To review the incidence, severity, and mechanisms of fentanyl-induced cough.
- To discuss factors influencing fentanyl-induced cough and effective preventive strategies.
Main Methods:
- Literature review of studies investigating fentanyl-induced cough.
- Analysis of factors including patient demographics, smoking history, and fentanyl administration parameters (rate, route, dose, concentration).
Main Results:
- Fentanyl-induced cough incidence and severity are linked to patient factors (age, ethnicity, smoking) and fentanyl administration specifics.
- Potential mechanisms include central sympathetic inhibition, vagal predominance, reflex bronchoconstriction, and histamine release.
Conclusions:
- Understanding the multifactorial nature of fentanyl-induced cough is crucial for anesthetic management.
- Preventive measures and anesthetic adjuncts administered prior to fentanyl can mitigate this unwanted side effect.
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