Objective:

To evaluate whether tegileridine pretreatment reduces fentanyl-induced cough (FIC) during anesthetic induction.

Approach:

• Study Design: A prospective, randomized, double-blind, placebo-controlled trial involving 216 adults scheduled for elective surgery.
• Intervention: Participants received either tegileridine 0.5 mg or normal saline before rapid fentanyl injection.
• Endpoints: Primary endpoint was FIC incidence within 2 minutes post-fentanyl injection; secondary endpoints included cough severity, hemodynamic changes, and adverse events.

Key Findings:

• FIC occurred in 31 of 108 patients in the placebo group (Group C) compared to 12 of 108 patients in the tegileridine group (Group T).
• Tegileridine reduced the relative risk of FIC by 61.3% (RR, 0.39; 95% CI, 0.21–0.71).
• Cough severity was significantly lower in the tegileridine group (P < 0.001).
• No significant differences in mean arterial pressure (MAP) and heart rate (HR) changes between groups.

Interpretation:

Tegileridine 0.5 mg pretreatment reduced the incidence and severity of FIC without causing immediate hemodynamic instability.

Limitations:

• The study was conducted at a single center, which may limit generalizability.
• The sample size may not be sufficient for broader safety conclusions.
• The optimal dose and timing for tegileridine pretreatment remain undetermined.

Conclusion:

Further active-comparator, dose-finding, and broader safety studies are required before routine clinical adoption.

Sources:

• Clinical Trial Registration