dezocine and Cough

To systematically review the effects of dezocine (DZC) on the occurrence rate and severity of opioid-induced cough (OIC).. Systematic review and meta-analysis DATA SOURCES: PubMed, Embase, Cochrane Library, Ovid, Web of Science as well as Chinese BioMedical Literature & Retrieval System, China National Knowledge Infrastructure, Wanfang and VIP Data were searched from 1978 to 31 December 2020.. All randomised controlled trials (RCTs) comparing DZC with placebo on the occurrence rate and severity of OIC.. All data were analysed by using RevMan V.5.3. Each outcome was tested for heterogeneity, and randomised-effects or fixed-effects model was used in the presence or absence of significant heterogeneity.. This meta-analysis demonstrated that DZC significantly inhibited OIC and may be used to manage OIC. More high-quality RCTs are needed to complement the safety of DZC.. CRD42019141255.

Topics: Analgesics, Opioid; Anesthesia, General; Bridged Bicyclo Compounds, Heterocyclic; Cough; Humans; Tetrahydronaphthalenes

Sufentanil is one of the opioids currently used to induce general anesthesia, and cough is one of the most common complications. Many drugs have been used to prevent sufentanil-induced cough (SIC), and dezocine is one of them. Dezocine is an analgesic, acting as partial antagonist of κ-receptors and agonist of μ-receptors. The purpose of our meta-analysis is to evaluate the efficacy of dezocine on SIC.. We searched multiple databases including PubMed, Embase, ScienceDirect, the Cochrane Library, and China National Knowledge Infrastructure databases (CNKI) to identify studies that met the inclusion criteria. This meta-analysis focused on the incidence and severity of SIC after dezocine intervention, as well as adverse effects. This meta-analysis was registered on PROSPERO with reference number ID: CRD 42020144943.. Five randomised controlled trials (RCTs) were identified, including 890 patients. Each study was a comparison of dezocine with an equal volume of 0.9% saline. When the injection dose of dezocine was 0.1 mg/kg, the incidence (pooled risk ratio (RR) = 0.03, [95% CI: 0.02 to 0.07], P < 0.00001, I. This meta-analysis showed that dezocine significantly reduced the incidence and severity of SIC in the induction of general anesthesia, but had no significant effect on vital signs. More high-quality RCTs are needed to complement existing conclusions.

Topics: Adult; Anesthesia, General; Bridged Bicyclo Compounds, Heterocyclic; Cough; Female; Humans; Male; Middle Aged; Severity of Illness Index; Sufentanil; Tetrahydronaphthalenes

The aim of this prospective randomized controlled study was to evaluate whether pretreatment with a small dose of dezocine could prevent remifentanil-induced cough in general anesthesia induction.. a prospective, randomized, controlled study.. A total of 210 patients receiving elective operative hysteroscopy from December 2018 to April 2019 were enrolled in the present study. They were randomly equally separated into dezocine group (n = 105) and control group (n = 105). Patients were intravenously pre-administrated with dezocine 0.03 mg/kg (diluted to 5 mL) or the same volume of normal saline 1 min prior to remifentanil infusion. One minute later, intravenous injection of propofol 1.5 mg/kg and cisatracurium 0.1 mg/kg were given to all patients for induction of general anesthesia. The counts of coughs occurred during the anesthesia induction period were recorded and the severity of cough was scaled.. There were 7 cases of mild cough in dezocine group and 18 cases of mild cough, 12 cases of moderate cough and 4 cases of severe cough in control group. The incidence rate of cough was significantly lower and the severity of cough was obviously relieved in dezocine group compared to control group (6.67% vs. 32.38%, P <  0.001). The two groups were not significantly different in heart rate and mean arterial pressure before the induction, before and after the intubation, and in operating time and postoperative visual analog scale pain scores.. This study recommends the efficacy and safety of a pretreatment with a small dose of dezocine in reducing remifentanil-induced cough during general anesthesia.. ChiCTR2000032035 . Date of registration: Retrospectively registered on 2020/04/18.

Topics: Adult; Aged; Analgesics, Opioid; Anesthesia, General; Bridged Bicyclo Compounds, Heterocyclic; Cough; Female; Humans; Hysteroscopy; Middle Aged; Prospective Studies; Remifentanil; Tetrahydronaphthalenes; Treatment Outcome; Young Adult

The best methods for inducing analgesia and sedation for gastroscopy are still debated but finding an adequate regimen of sedation/analgesia is important. Stimulation of the larynx under sedation can cause reflex responses. Propofol with opioids has been recommended for gastroscopy sedation but the effects on cough reflex suppression remain unclear. This trial will evaluate the effects of propofol combined with small doses of dezocine, oxycodone, sufentanil or fentanyl for gastroscopy. We hypothesise that better performance may be obtained with a combination of propofol and oxycodone. We will observe the incidence and degree of reflex coughing and gagging under sedation when using propofol combined with one of the above drugs or propofol alone.. This will be a prospective, randomised, double-blind, controlled trial. ASA I-II level patients aged 18-65 years and scheduled for gastroscopy will be included. It is planned that 500 subjects will be randomised to intravenously receive 2-2.2 mg/kg propofol plus 0.5-0.8 μg/kg fentanyl (fentanyl group), 2-2.2 mg/kg propofol plus 0.05-0.08 μg/kg sufentanil (sufentanil group), 2-2.2 mg/kg propofol plus 0.04-0.05 mg/kg dezocine (dezocine group), 2-2.2 mg/kg propofol plus 0.04-0.05 mg/kg oxycodone (oxycodone group), or 2.4-3 mg/kg propofol plus 2-2.5 mL saline (control group) for sedation. The primary endpoint is the incidence and degree of reflex coughing and gagging. The secondary endpoints include the occurrence of discomfort or side effects, the use of jaw thrust, assisted ventilation or additional propofol, recovery time, duration of procedure and Steward score.. This study has been approved by the Institutional Ethics Committee for Clinical Research of Zhongda Hospital, Affiliated to Southeast University (No. 2015ZDSYLL033.0). The results of the trial will be published in an international peer-reviewed journal.. This study has been registered with the Chinese Clinical Trial Register (No. ChiCTR-ICR-15006952).. At the time of manuscript submission, the study was in the recruitment phase.

Topics: Adolescent; Adult; Aged; Analgesics, Opioid; Antitussive Agents; Bridged Bicyclo Compounds, Heterocyclic; Conscious Sedation; Cough; Double-Blind Method; Drug Therapy, Combination; Female; Fentanyl; Gagging; Gastroscopy; Humans; Hypnotics and Sedatives; Male; Middle Aged; Pain; Propofol; Prospective Studies; Reflex; Research Design; Tetrahydronaphthalenes; Young Adult

Opioid-induced cough during induction of general anesthesia is a common phenomenon. Dezocine, a partial μ-receptors agonist and κ-receptors antagonist, has been documented effectively suppressing fentanyl-induced cough in general anesthesia induction. However, the effect of dezocine on sufentanil-induced cough is still unknown.. A total of 370 patients (American Society of Anesthesiologists physical status I-II), aged 18-70 years, undergoing elective surgery, were randomly divided into a control group (group C) and a dezocine group (group D) (n=185 in each group). Patients received dezocine 0.1mg/kg or an equal volume of 0.9% normal saline 2 min prior to intravenous sufentanil (0.5 μg/kg). The incidence and reflex degree of cough in patients were evaluated within 2 min after the injection of sufentanil in anesthesia induction period.. No patient in group D had cough and 59 patients in group C had cough (severity of cough: mild, 7%; moderate, 11.4%; severe, 13.5%). The occurrence and reflex degree of cough in group D was significantly lower than that in group C (P=0.000). The highest heart rate (HR) and invasive blood pressure (IBP) values were higher in group C than those in group D (P<0.01) within 2 min after sufentanil administration, althought these values remained within safe limits.. The results of current study suggest that administration of Dezocine 0.1mg/kg may effectively prevent the occurrence and reflex degree of sufentanil-induced irritating cough in general anesthesia induction in patients.

Topics: Adolescent; Adult; Aged; Analgesics, Opioid; Anesthesia, General; Anesthetics, Intravenous; Blood Pressure; Bridged Bicyclo Compounds, Heterocyclic; Cough; Female; Heart Rate; Humans; Incidence; Male; Middle Aged; Reflex; Sufentanil; Tetrahydronaphthalenes; Young Adult

To evaluate the suppressive effect of intravenous dezocine on fentanyl-induced cough during the induction of general anesthesia.. A total of 120 patients, American Society of Anesthesiologists (ASA) physical status I-II, were randomized into two equally sized groups (n = 60). These two groups were given either intravenous dezocine 0.1 mg/kg or a matching placebo (equal volume of 0.9% saline) 10 min before the induction of general anesthesia. Patients were induced with midazolam 0.1 mg/kg, fentanyl 5 μg/kg, propofol 1-1.5 mg/kg, and suxamethonium 1.5 mg/kg. The injection time of fentanyl was less than 2 s in all patients. The occurrence of cough was recorded 2 min after fentanyl bolus.. No patient in the dezocine group had cough, and 42 patients in the control group had cough. This difference was statistically different between these two groups (P = 0.000).. These results demonstrate that intravenous dezocine 0.1 mg/kg 10 min prior to induction was effective in suppressing fentanyl-induced cough in our patients.

Topics: Anesthesia, General; Anesthetics, Intravenous; Bridged Bicyclo Compounds, Heterocyclic; Cough; Double-Blind Method; Drug Interactions; Female; Fentanyl; Humans; Male; Middle Aged; Tetrahydronaphthalenes

Cough is often observed when administrating a bolus of opioids. Opioid-induced cough (OIC) is mostly transient, benign and self-limiting, but could be associated with adverse effects. Numerous pharmacological and non-pharmacological interventions have been used to manage OIC with controversial efficacy and safety. Recent studies suggested that, pretreatment of intravenous dezocine (DZC) could completely suppress OIC during anaesthesia induction. To address this knowledge lack, we will perform a systemic review and meta-analysis to evaluate the efficacy of DZC on OIC and possible complications. We provide here a protocol that will outline the methods and analyses planned for the systematic review.. PubMed, Embase, Cochrane Library, Web of Science as well as Chinese BioMedical Literature & Retrieval System (SinoMed), China National Knowledge Infrastructure, Wanfang Data and VIP Data will be searched from 1978 to 31 December 2019 to identify all randomised controlled trials comparing DZC with placebo on the incidence and severity of OIC. Primary outcomes of interest include the incidence and severity of OIC. Secondary outcomes of interest include possible complications or adverse effects of DZC. Two authors will independently extract relevant variables and outcome data. For continuous variables, treatment effects will be calculated as weighted mean difference and 95% CI. For dichotomous data, treatment effects will be calculated as OR and 95% CI. Each outcome will be tested for heterogeneity, and randomised-effects or fixed-effects model will be used in the presence or absence of significant heterogeneity. Sensitivity analyses will be done by examining the influence of statistical model and individual trial(s) on estimated treatment effects. Publication bias will be explored through visual inspection of funnel plots of the outcomes. Statistical significance will be defined as p<0.05.. This study is a protocol of meta-analysis of previously published literatures, ethical approval was not necessary according to the Ethical Committee of Fuwai Hospital. The study will be submitted to a peer-reviewed journal and disseminated via research presentations.. CRD42019141255.

Topics: Analgesics, Opioid; Anesthesia, General; Bridged Bicyclo Compounds, Heterocyclic; Cough; Humans; Meta-Analysis as Topic; Research Design; Systematic Reviews as Topic; Tetrahydronaphthalenes