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

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.