Advantage of intravenous fentanyl use for extubation induced cough prevention after thyroid surgery. A randomized controlled trial

Abstract

Background and goal of study: During tracheal extubation endotracheal tube can cause coughing, agitation, and changes in the hemodynamic parameters. Extubation induced cough after thyroid surgery increases risk of postoperative bleeding which is a life-threatening complication. The Difficult Airway Society recommends use of remifentanil prior to extubation for smooth and safe extubation [1]. The goal of study was to evaluate the benefits of intravenous fentanyl for prevention of extubation - induced cough during thyroid surgery. Materials and methods: Study was performed in Hospital of Lithuanian University of Health Sciences Kaunas Clinics Anaesthesiology department. ASA class I - III patients who were scheduled for elective thyroid surgery and met inclusion criteria were chosen for the study. Patients were randomly divided into two groups: A and B. Group A patients received 0,05 mg fentanyl intravenously up to 30 minutes before tracheal extubation, standard practice was performed on group B. Data describing demographics, hemodynamic parameters before and after extubation, agitation level, cough during extubation, and fentanyl administration characteristics was collected. Both groups were compared. χ2, Mann–Whitney and Student–t tests were used for comparison of data, p value <0,05 was considered statisticaly significant. Results and discussion: 92 patients were randomized - group A (n = 41 (44,6%)) and group B (n = 51 (55,4%)). Sex, age, ASA class did not differ between the groups. To determine the occurrence of cough during the extubation data of 84 patients was analyzed: group A n=38 patients, group B n=46 patients. Cough occurred for 8 (21,1%) patients in group A, and for 21 (45,7%) in B group. […].