Effect of tramadol on fentanyl induced cough: A double-blind, randomized, controlled study

Abstract

BackgroundTramadol has NMDA antagonist effect and reported to have antitussive effect. The aim of this study to assess the effect of preoperative i.v. tramadol compared to placebo on the incidence and severity of fentanyl induced cough.MethodIn a prospective, randomized, double-blind study, 100 patients ASA I, age 18–50 years old, scheduled for elective laparoscopic surgeries under general anesthesia. Patients were randomly allocated to one of two groups: Tramadol group received i.v. tramadol 1 mg/kg in 100 ml saline and control group received 100 ml saline over 15 min before induction of anesthesia. The incidence and severity of cough was assessed following injection of fentanyl 2 μg/kg. The postoperative analgesic requirements, nausea, and vomiting were also recorded.ResultsThe incidence of FIC was significantly less in tramadol treated group being [10 (20%)], compared to control group being [19 (38%)] (p < 0.05). Regarding the grade of FIC; 7 out of 10 in tramadol group and 12 out of 19 in control group showed mild form, 3 out of 10 in tramadol group and 4 out of 19 in control group showed moderate form and 3 out of 19 in control group with no patients in tramadol group showed severe form. The postoperative analgesic requirements was significantly less in tramadol group (p < 0.05) with no significant difference in postoperative nausea and vomiting between the two groups.ConclusionTramadol 1 mg/kg i.v. infusion 15 min before induction of anesthesia reduced the incidence and severity of cough after fentanyl injection 2 μg/kg with reduction of postoperative analgesic requirements and without changes in postoperative nausea and vomiting compared to placebo.