Comparison of Preoperative Acupressure, Incentive Spirometry, and Nebulisation with Lignocaine in Reducing Fentany-induced Cough: A Randomised Controlled Study
Introduction: Fentanyl bolus during induction often leads to cough. It is usually benign, but in some cases, it can be explosive and life-threatening. The incidence of Fentany-induced Cough (FIC) varies from 18% to 65%. Aim: To compare the effect of acupressure, incentive spirometry, and nebuli...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2023-08-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://www.jcdr.net/articles/PDF/18358/63173_CE[Ra1]_F[SK]_QC(KK_RDW_IS)_PF1(VD_OM_KM)_PFA_NC(VD_KM)_PN(KM).pdf |
| Summary: | Introduction: Fentanyl bolus during induction often leads to
cough. It is usually benign, but in some cases, it can be explosive
and life-threatening. The incidence of Fentany-induced Cough
(FIC) varies from 18% to 65%.
Aim: To compare the effect of acupressure, incentive spirometry,
and nebulisation with lignocaine on the incidence and severity
of FIC.
Materials and Methods: This single blind randomised controlled
study was conducted in Department of Anaesthesia, Himalayan
Institute of Medical Sciences, HIMS, Dehradun, Uttarakhand,
India over a period of nine months from May 2019 to February
2020. Four hundred patients, aged 18-60 years, of either sex,
scheduled for elective surgery, were randomly assigned to four
groups: acupressure group (A), incentive spirometry group (S),
nebulisation with lignocaine group (N), and control group (C). All
patients received undiluted fentanyl at a dose of 2 mcg/kg over
five seconds. Episodes of cough within 60 seconds of fentanyl
administration were classified as FIC, and the severity was
graded based on the number of coughs (mild: 1-2, moderate:
3-4, severe: 5 or more). The time of onset of FIC was recorded.
Hemodynamic changes and adverse effects due to fentanyl
injection and the procedure were noted. The Kruskal-Wallis
test, Mann-Whitney U test, and Chi-square test were used for
statistical analysis.
Results: There were no differences among the four groups in
terms of patients’ characteristics and a American Society of
Anaesthesiologist (ASA) status. The incidence of FIC was higher
in Group C (37%) compared to Group A (8%), S (12%), and N
(10%), which was statistically significant (p-value<0.001). There
was no significant difference in the incidence of FIC between
Groups A, S, and N. Severe cough were observed in nine
patients in the control group, one patient in the nebulisation and
spirometry group, and none in the acupressure group.
Conclusion: Non pharmacological methods such as acupressure
and incentive spirometry were equally effective in reducing the
incidence of FIC as the pharmacological methods and are more
cost effective. |
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| ISSN: | 2249-782X 0973-709X |