RESUMO
OBJECTIVE: To observe the effect of optimizing anesthetic injecting sequence during induction on fentanyl-induced coughing. METHODS: One hundred and twenty ASA I or II elective patients undergoing general anesthesia were randomly allocated to optimized group or control group: the optimized group induced with midazolam 0.06 mg/kg, followed by fentanyl 1 mg/kg at 1 min later, vecuronium 0.1 mg/kg at 1 min 55 s, propofol 1.5-2 mg/kg at 2 min, a second dose of 3 mg/kg fentanyl at 2 min 20 s, intubated at time 5 min; the control group was induced with the same medication but all the fentanyl (4 mg/kg) was injected at time 1 min. Coughing after fentanyl injection was observed and hemodynamic parameters were recorded. RESULTS: Hemodynamic changes were identical between the two groups indicated similar intubation response suppression. The incidence of fentanyl-induced coughing was significantly lower in the optimized group (4/60) than in the control group (23/60) (P < 0.01). CONCLUSION: Optimizing anesthetic injecting sequence during induction by separate fentanyl into two boluses significantly reduce fentanyl-induced coughing without affecting intubation response suppression.