Keywords
Fentanyl; Cough; Hydroxyzine; Premedication; Anesthesia
Abstract
Study Objective: To observe the effect of hydroxyzine used for premedication on fentanyl -induced cough during induction of anesthesia.
Design: Prospective, randomized, single -blinded, clinical trial.
Setting: Department of Pediatric Surgery and operating room of a Training and Research Hospital.
Patients: 90 ASA physical status I pediatric patients, aged 3 and 12 years, scheduled for elective surgery during general anesthesia.
Interventions: Patients were randomized into one of two groups: a control group (Group C) and a hydroxyzine group (Group H). Group H patients were given 1 mg kg -1 hydroxyzine with 10 ml water to drink 2 h before surgery. No premedication was performed on Group C patients. In both groups 2 µg kg -1 fentanyliv were given for 3 sec to patients before induction of anesthesia.
Measurements: Patients sedation states were evaluated using the Ramsay Sedation Scale (RSS) in the operating room. The presence, onset and severity of cough were recorded.
Main Results: The incidences of cough were 11.1% in Group H and 51.1% in Group C (p<0.0001). All coughs in Group H were mild. In Group C, however, 24.4% of coughs were mild, 15.6% were moderate and 11.1% were severe. Significant differences were observed between the two groups in terms of moderate and severe cough (p=0.026 and p=0.028, respectively). RSS was significantly in favor of Group H (p<0.0001). When patients were given hydroxyzine an absolute risk reduction of -0.4 and a relative risk reduction of -0.78 were observed compared to the control group, and the number needed to treat was -2.5.
Conclusion: Hydroxyzine administered orally during the preoperative period is effective in preventing both the incidence and severity of fentanyl -induced cough in child patients. Our results demonstrate that hydroxyzine is a suitable drug for reducing this cough.
Citation
Arslan Z, Ozmen O, Cevizci MN and Karakaya MA. The Effect of Hydroxyzine on Fentanyl -Induced Cough in Pediatric Patients: A Prospective, Randomized, Controlled Trial. SM J Anesth. 2019; 4(1): 1015.