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Intravenous Fentanyl Can Be Used Appropriately in Elective Surgery Patients: Presented at ASA By Arushi Sinha, PhD SAN FRANCISO, CA -- October 19, 2007 -- Fentanyl can be administered safely as an intravenous infusion in a rapid sequence in patients undergoing general surgery, researchers reported here at the Annual Meeting of the American Society of Anesthesiologists (ASA). Intravenous fentanyl is a tool used to manage cardiopulmonary activity while a patient is under anaesthesia. However, the use of fentanyl has been associated with an increased risk of cough during anaesthesia. To better characterise the potential adverse effects of fentanyl, researchers led by Ursula Schäpermeier, MD, Anaesthesiologist, Department of Anaesthesiology and Perioperative Medicine, Asklepios Klinik Langen, Langen, Germany, conducted a randomised, single-blind, placebo-controlled study. The study enrolled 476 patients with no history of upper respiratory tract infection who were to undergo elective general surgery with anaesthesia. Patients were then randomised to receive: fentanyl 1.5 mcg/kg injected over 2, 5, or 10 seconds; or placebo saline solution injected over 2 seconds. The primary endpoint of this study was cough within 5 minutes of injection completion. The secondary endpoint was any other adverse symptoms -- such as nausea or vomiting -- within 5 minutes of completing the injection. Though the study was initially designed to enrol 680 patients, new patient enrolment was cut off at 476 when the results yielded a very low incidence of injection-related adverse effects. Patients exhibited an incidence of cough at the rate of 3%, 3%, and 6% in the fentanyl group (2 s, 5s, and 10s, respectively), and 2% in the placebo group. There was no difference between the groups (P =.374). "In this study, we saw a 6% incidence of symptoms, and there was no difference between fentanyl and placebo," said Dr. Schäpermeier. She added, "We think that it is safe to give fentanyl in a rapid sequence without any adverse effects." Based on these results, the authors concluded that the incidence of cough among patients dosed with 1.5 mcg/kg of fentanyl is between 3% and 6%, not significantly variant from placebo, and is not influenced by the rate of dose delivery. [Presentation title: Cough After IV Induction With Fentanyl - Clinically Relevant? Abstract A1040] E-mail this page to a friend or colleague! To print, use this version