Intravenous Vecuronium Pretreatment Reduces Fentanyl-induced Cough

  Objective  To observe the effect of intravenous vecuronium pretreatment on fentanyl-induced cough (FIC).

  Methods  Totally 160 American Society of Anesthesiologists class I-II patients, aged 18-65 years within normal weight, scheduled for elective surgery, were randomly assigned to receive intravenous vecuronium 0.01 mg/kg (pretreatment group) or placebo (normal saline, control group) 5 minutes prior to the administration of fentanyl 3 μg/kg in a randomized and double-blind fashion. Any episode of cough was classified as coughing, and graded as mild (1-2), moderate (3-4), or severe (5 or more). We recorded the timing and severity of cough and monitored the vital signs and discomforts such as dizziness, tinnitus, nausea/vomiting, apnea, and dysrhythmia.

  Results  The gender distribution showed no significant difference between two groups (P=0.081). The incidence of cough was 21.3% (17/80) in pretreatment group and 42.5% (34/80) in control group (P=0.004). The incidence of moderate and severe cough was significantly higher in the control group (19/34, 55.9%) than in pretreatment group (6/17, 35.3%) (P < 0.005). There was no significant difference between these two groups in the timing of cough. Vital signs were stable in both groups and no difference was shown in discomforts.

  Conclusion  Vecuronium pretreatment can effectively reduce the incidence and severity of FIC.