Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0010200 (cough)
 23,843 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The alpha-adrenergic agonists have been demonstrated to have synergistic effects with opioids and local anesthetics in animal research. The present study was performed to determine whether the addition of adrenaline improves the analgesic effects of an epidural infusion of a combination of fentanyl and bupivacaine after abdominal surgery. We studied 90 ASA 1 or 2 patients scheduled for abdominal surgery under epidural anaesthesia, with or without general anaesthesia. Patients were randomly divided into two groups to receive a postoperative epidural infusion of fentanyl 5 micrograms/ml in bupivacaine 0.2%, with or without adrenaline 5 micrograms/ml, at a rate of 2 ml/h for more than 48 hours. Postoperative pain relief was assessed using visual analog scales (VAS), both at rest and during coughing, at 2, 24, and 48 hours after surgery. The number of rescue analgesics and side-effects such as nausea, vomiting, pruritus, respiratory depression, headache, muscle weakness, and hypotension were recorded. Patients who received adrenaline (n = 40) reported significantly lower mean VAS scores than those who received no adrenaline (n = 37), both at rest at 24 hours postoperatively and during coughing at 24 and 48 hours. The number of additional analgesics and incidence of side-effects did not differ between groups. In conclusion, the results of the present study demonstrate that the addition of adrenaline to a combination of fentanyl and bupivacaine improves the quality of epidural analgesia after abdominal surgery. Under the conditions of the study, we did not detect any disadvantage from the addition of adrenaline.
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PMID:Does adrenaline improve epidural bupivacaine and fentanyl analgesia after abdominal surgery? 1151 59

An admixture of thiopentone and propofol was evaluated against propofol for laryngeal mask airway (LMA) insertion. Eighty-one ASA 1 and 2 18- to 65-year-old patients, premedicated with 7.5 mg midazolam orally were assigned randomly to receive either propofol 1% or an admixture of thiopentone and propofol (1.25% and 0.5% respectively), both at a dose of 0.25 ml x kg(-1). Satisfactory conditions for insertion were achieved with the admixture, which was comparable to propofol (73% vs 85%, P>0.05). There was no statistical difference in the incidence or severity of gagging, coughing, inadequate jaw relaxation and laryngospasm. The incidence of hypotension was lower in the admixture group (51% vs 78%, P=0.02). The duration of apnoea was not different between the admixture and propofol group (mean 103s vs 109s respectively, P>0.05). We conclude that thiopentone/propofol admixture can be a suitable alternative to propofol for LMA insertion, producing less hypotension while allowing cost savings of up to 45%. An admixture of thiopentone and propofol (1.25% and 0.5% respectively) can produce suitable conditions compared to propofol 1%, for laryngeal mask insertion. In addition to cost containment, the admixture also produces less hypotension.
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PMID:The use of thiopentone/propofol admixture for laryngeal mask airway insertion. 1126 9

A 30-year-old man was diagnosed as having ulcerative colitis and was treated with 2,250 mg/day of 5-aminosalicylic acid (5-ASA). After 4 weeks of the administration, the patient complained of cough and fever and was admitted to our hospital. His chest radiograph showed infiltrative shadows bilaterally in the lung fields. Peripheral blood analysis indicated eosinophilia. We confirmed eosinophilic pneumonia by bronchoalveolar lavage and transbronchial lung biopsy. Improvement in clinical symptoms and radiological findings was obtained after the cessation of 5-ASA and initiation of prednisolone. Finally, mesalazine-induced eosinophilic pneumonia was diagnosed on the basis of his clinical course. The literature contains a few reports on patients with mesalazine-induced eosinophilic pneumonia.
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PMID:[A case of eosinophilic pneumonia possibly associated with 5-aminosalicylic acid (5-ASA)]. 1516 57

This study of sixty ASA grade 1 or 2 children, aged 1 to 12 years, undergoing elective ophthalmic procedures, compared the use of the laryngeal mask airway (LMA) with that of an endotracheal tube. Changes in intraocular pressure and haemodynamic parameters, and intraoperative and postoperative complications were measured Patients were randomly allocated into two groups of 30 patients. In group 1, the airway was secured with an LMA and in group 2 with an endotracheal tube. A standard technique of general anaesthesia incorporating positive pressure ventilation was used in both groups. The changes in intraocular pressure, heart rate (HR) and mean arterial pressure (MAP) were observed before and after insertion of the airway device, two minutes after insertion, and pre and post removal of the device. The incidence of airway complications was also noted. There was no significant change in mean intraocular pressure after insertion of the LMA, but removal caused a significant increase to 19.3 +/- 7.6 mmHg (from a baseline of 13.9 +/- 4.3 mmHg). In the endotracheal tube group, intubation increased the mean intraocular pressure significantly to 19.9 +/- 7.3 mmHg (from a baseline of 13.1 +/- 4.0 mmHg) and extubation caused an increase to 24.6 +/- 10.4 mmHg which was clinically as well as statistically significant. The incidence of postoperative coughing was lower in the LMA group, but the incidence of vomiting higher. Two patients had displacement of the LMA during the procedure. We conclude that the use of an LMA is associated with less increase in intraocular pressure than the use of an endotracheal tube in children.
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PMID:Comparison of laryngeal mask airway with tracheal tube for ophthalmic surgery in paediatric patients. 1526 35

Abdominal hysterectomy is associated with moderate to severe postoperative pain. We randomly divided 40 patients (ASA status I-II) undergoing elective abdominal hysterectomy into 2 groups: group P received an infusion of normal saline 5 mL/h via a catheter placed intraperitoneally at the end of surgery, and group L received 0.25% levobupivacaine 12.5 mg/h (5 mL/h). Ketobemidone was administered IV via a patient-controlled analgesia pump as a rescue analgesic in all patients. The catheter was removed after 24 h. Incisional pain, deep pain, and pain on coughing were assessed 1, 2, 3, 4, 8, 16, and 24 h after surgery by using a visual analog scale. Ketobemidone consumption during 0-72 h was recorded. Time to sit, walk, eat, and drink; home discharge; and plasma concentrations of levobupivacaine were also determined. Pain at the incision site, deep pain, and pain on coughing were all significantly less in group L compared with group P at 1-2 h after surgery. After 4 h, the mean visual analog scale pain scores at rest and during coughing remained <3 cm during most time periods. Total ketobemidone consumption during 4-24 h was significantly less in group L compared with group P (mean, 19 versus 31 mg, respectively). A less frequent incidence of postoperative nausea, but not vomiting, was also found during 4-24 h in group L compared with group P (P < 0.025). Total and free plasma concentrations of levobupivacaine were small. We conclude that levobupivacaine used as an infusion intraperitoneally after elective abdominal hysterectomy has significant opioid-sparing effects.
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PMID:Postoperative pain after abdominal hysterectomy: a double-blind comparison between placebo and local anesthetic infused intraperitoneally. 1538 71

Coughing on emergence can result in a number of undesirable side effects, including hypertension, tachycardia, tachyarrhythmias, increased intracranial pressure, and increased intraocular pressure. The efficacy of endotracheal spraying with lidocaine at the time of intubation in preventing coughing on emergence is unknown. In a double-blind placebo-controlled study, we randomized 50 ASA physical status I and II patients presenting for elective gynecological surgery <2 h duration to receive either endotracheal lidocaine 160 mg or placebo before intubation. Both groups were comparable in terms of demographics and intraoperative conditions. The incidence of coughing before tracheal extubation was less frequent in the lidocaine group (26%) than in the placebo group (66%, P < 0.01), as was the incidence after tracheal extubation (4% versus 30%, P = 0.022). This study supports the use of endotracheal lidocaine before intubation in patients undergoing general anesthesia for surgery <2 h duration where coughing on emergence is undesirable.
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PMID:Laryngotracheal topicalization with lidocaine before intubation decreases the incidence of coughing on emergence from general anesthesia. 1538 85

IV lidocaine is effective in suppressing the cough reflex of tracheal intubation, extubation, bronchography, bronchoscopy, and laryngoscopy. We investigated this effect of lidocaine on fentanyl-induced cough in 502 patients of ASA physical status I and II scheduled for elective surgery. The patients were assigned to 2 equal groups to receive either lidocaine 1.5 mg/kg or placebo (0.9% saline) over 5 s 1 min before the administration of fentanyl 3 mug/kg in a randomized and double-blind fashion. Coughs were classified as coughing and graded as mild (1-2), moderate (3-4), or severe (5 or more). The results of the study suggest that IV lidocaine 1.5 mg/kg, when administered 1 min before fentanyl, is significantly effective in suppressing fentanyl-induced cough compared to placebo (0.9% saline) (218 versus 165 patients) (P < 0.002) but without affecting the severity of cough (P > 0.05).
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PMID:Intravenous lidocaine suppresses fentanyl-induced coughing: a double-blind, prospective, randomized placebo-controlled study. 1556 56

Both dextromethorphan (DM) and IV lidocaine improve postoperative pain relief. In the present study, we evaluated the interaction of DM and IV lidocaine on pain management after laparoscopic cholecystectomy (LC). One-hundred ASA physical status I or II patients scheduled for LC were randomized into four equal groups to receive either: (a) chlorpheniramine maleate (CPM) intramuscular injection (IM) 20 mg and IV normal saline (N/S) (group C); (b) DM 40 mg IM and IV N/S (group DM); (c) CPM 20 mg IM and IV lidocaine 3 mg . kg(-1) . h(-1) (group L); or (d) DM 40 mg IM and IV lidocaine (group DM+L). All treatments were administered 30 min before skin incision. Analgesic effects were evaluated using visual analog scale pain scores at rest and during coughing, time to meperidine request, total meperidine consumption, and the time to first passage of flatus after surgery. Patients of the DM+L group exhibited the best pain relief and fastest recovery of bowel function among groups. Patients in the DM and L groups had significantly better pain relief than those in the C group. The results showed an additional effect on pain relief and a synergistic effect on recovery of bowel function when DM was combined with IV lidocaine after LC.
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PMID:The interaction effect of perioperative cotreatment with dextromethorphan and intravenous lidocaine on pain relief and recovery of bowel function after laparoscopic cholecystectomy. 1567 74

We designed this study to evaluate the effect of injection time and smoking on fentanyl-induced cough. Four-hundred-fifty ASA class I-II patients, aged 18-80 yr and weighing 40-90 kg, scheduled for elective surgery were included. All patients received fentanyl (100 microg for patients weighing 40-69 kg and 150 microg for patients weighing 70-90 kg for clinical convenience) via the proximal port of a peripheral IV line on the forearm. Patients were randomly assigned to 3 groups of 150 patients each. Patients in Group I received fentanyl injection over 2 s, whereas for patients in Groups II and III the fentanyl was injected at a constant rate over 15 s and 30 s, respectively. We recorded the number of coughs of each patient during and 30 s after fentanyl injection. The incidence of cough was 18% in group I, 8% in Group II, and 1.3% in Group III, significantly less (P < 0.05) with a longer injection time. Current smokers had a less frequent incidence of cough than nonsmokers; however, this effect was only significant in light smokers (<10 cigarettes per day or <10 smoking years or <10 pack-years). In conclusion, a longer injection time reduces the incidence of fentanyl-induced cough, and light smoking may be a protective factor against fentanyl-induced cough.
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PMID:Prolonged injection time and light smoking decrease the incidence of fentanyl-induced cough. 1611 73

We determine the feasibility of using the intubating laryngeal mask airway Fastrach (ILM) as a ventilatory device during emergence from anesthesia after use as an airway intubator in patients undergoing carotid endarterectomy. Thirty-five patients (ASA 2-3, 53-84 yr) were studied. Induction was with midazolam/fentanyl/etomidate and maintenance was with sevoflurane 1-2% in O2 33-50% and N2O. Neuromuscular blockade was with cisatracurium. Tracheal intubation was with a flexible lightwand via the ILM. After successful intubation, the ILM remained in the pharynx, but with the cuff deflated. After surgery, but before anesthesia was discontinued, baseline cardiovascular variables were recorded. The ILM cuff was then reinflated, the tracheal tube removed, the anesthesia breathing system connected to the ILM and anesthesia discontinued. Any changes in the cardiovascular variables greater than +/- 20% baseline values were noted from cuff reinflation to 1 minute after ILM removal. Any adverse respiratory (laryngospasm, coughing, gagging, stridor, SpO2 <94%, end-tidal carbon dioxide >45 mmHg, regurgitation/aspiration) or electrocardiographic (ST segment or rhythm changes) events were also noted. Patients were questioned about postoperative sore throat at 2 and 24 hr. ILM insertion and intubation through the ILM were successful in all patients. Adequate ventilation was achieved in all patients before intubation and after extubation. The mean (range) time taken from cuff reinflation to ILM removal was 9 (5-21) min. The rate pressure product remained within +/- 20% baseline values in all patients. There were no adverse respiratory or electrocardiographic events. There were no adverse neurological events. The surgical field was satisfactory. Postoperative sore throat occurred in 14% at 2 hr and 0% at 24 hr. We conclude that the ILM can be used as a ventilatory device for emergence from anesthesia after use as an airway intubator for carotid endarterectomy.
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PMID:The intubating laryngeal mask airway Fastrach for emergence after carotid endarterectomy. 1638 Dec 61


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