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    Art:10.1007/s00540 011 1318 X

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    Iqbal Harziky
    The letter discusses a recent article that demonstrated dezocine suppressed fentanyl-induced cough during anesthesia induction. However, the letter notes that 1) fentanyl at standard doses does not usually cause significant cough issues clinically, and 2) the original article contained a clerical error in its description of how dezocine works. Specifically, the letter states that dezocine should be said to antagonize kappa receptors, which in turn antagonize fentanyl-activated mu receptors, thereby reducing cough rather than inducing it. The letter also questions whether the original study provided sufficient evidence to support its claims about dezocine's mechanisms of action in suppressing fentanyl-induced cough.

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    Art:10.1007/s00540 011 1318 X

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    Iqbal Harziky
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    The letter discusses a recent article that demonstrated dezocine suppressed fentanyl-induced cough during anesthesia induction. However, the letter notes that 1) fentanyl at standard doses does not usually cause significant cough issues clinically, and 2) the original article contained a clerical error in its description of how dezocine works. Specifically, the letter states that dezocine should be said to antagonize kappa receptors, which in turn antagonize fentanyl-activated mu receptors, thereby reducing cough rather than inducing it. The letter also questions whether the original study provided sufficient evidence to support its claims about dezocine's mechanisms of action in suppressing fentanyl-induced cough.

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    The letter discusses a recent article that demonstrated dezocine suppressed fentanyl-induced cough during anesthesia induction. However, the letter notes that 1) fentanyl at standard doses does not usually cause significant cough issues clinically, and 2) the original article contained a clerical error in its description of how dezocine works. Specifically, the letter states that dezocine should be said to antagonize kappa receptors, which in turn antagonize fentanyl-activated mu receptors, thereby reducing cough rather than inducing it. The letter also questions whether the original study provided sufficient evidence to support its claims about dezocine's mechanisms of action in suppressing fentanyl-induced cough.

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    © All Rights Reserved
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    18 views1 page

    Art:10.1007/s00540 011 1318 X

    Uploaded by

    Iqbal Harziky
    The letter discusses a recent article that demonstrated dezocine suppressed fentanyl-induced cough during anesthesia induction. However, the letter notes that 1) fentanyl at standard doses does not usually cause significant cough issues clinically, and 2) the original article contained a clerical error in its description of how dezocine works. Specifically, the letter states that dezocine should be said to antagonize kappa receptors, which in turn antagonize fentanyl-activated mu receptors, thereby reducing cough rather than inducing it. The letter also questions whether the original study provided sufficient evidence to support its claims about dezocine's mechanisms of action in suppressing fentanyl-induced cough.

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    of 1

    J Anesth (2012) 26:470

    DOI 10.1007/s00540-011-1318-x

    LETTER TO THE EDITOR

    Dezocine: a novel drug to prevent fentanyl-induced cough


    during general anesthesia induction?
    Qiang Sun Wei Zhou Bo Wu Mu-huo Ji
    Yong G. Peng

    Received: 31 October 2011 / Accepted: 19 December 2011 / Published online: 7 January 2012
    Japanese Society of Anesthesiologists 2012

    To the Editor:
    We read with great interest the recently published article
    by Dr. Sun et al. [1], in which the authors demonstrated
    that intravenous administration of 0.1 mg/kg dezocine
    10 min before general anesthesia completely suppressed
    fentanyl-induced cough during induction. The results were
    very inspirational and astonishing. However, we note that
    standard dose and usage of fentanyl do not cause a significant problem in clinical practice. Furthermore, we find
    that there is a clerical error in this article. The authors
    suggested that dezocine antagonizes j receptors, which in
    turn antagonize fentanyl-activated l receptors, thereby
    inducing cough. This statement was in disagreement with
    the results of their article, in which they showed dezocine
    was effective in suppressing fentanyl-induced cough during
    general anesthesia induction. From this point of view, it
    should be restated that dezocine antagonizes j receptors,
    which in turn antagonize fentanyl-activated l receptors,
    thereby reducing cough.
    In addition, the mechanisms of fentanyl-induced cough
    have been multifactorial including opioid receptors, C-fiber
    receptors, rapidly adapting pulmonary stretch receptors,
    Q. Sun  B. Wu
    Department of Anesthesiology, Institution of Stomatology,
    College of Stomatology, Nanjing Medical University, Nanjing,
    Peoples Republic of China
    W. Zhou  M. Ji (&)
    Department of Anesthesiology, Jinling Hospital, School
    of Medicine, Nanjing University, 305 East Zhongshan Road,
    Nanjing 210002, Peoples Republic of China
    e-mail: ufo5201981@gmail.com
    Y. G. Peng
    Department of Anesthesiology, University of Florida College
    of Medicine, Gainesville, FL, USA

    123

    histamine, and the citrate in the fentanyl injection fluid, just


    as the authors suggested [1]. However, the authors provided inadequate evidence to support their claim that
    dezocine counteracted the action of fentanyl by a central
    gating mechanism of cough suppression, predominantly via
    C-fiber receptors, or, whether dezocine inhibited the
    release of histamine by antagonizing and suppressing
    cough reflex? These speculations may have overextrapolated their study results because there is no evidence supporting the mechanisms of dezocine involved in the
    suppression of fentanyl-induced cough during general
    anesthesia induction. Therefore, more studies are needed to
    clarify the effects and the precise mechanisms of dezocine
    involved in suppressing fentanyl-induced cough during
    general anesthesia induction.
    Conflict of interest The authors have no potential conflicts of
    interest to disclose.

    Reference
    1. Sun ZT, Yang CY, Cui Z, Zhang J, Han XP. Effect of intravenous
    dezocine on fentanyl-induced cough during general anesthesia
    induction: a double-blinded, prospective, randomized, controlled
    trial. J Anesth 2011 [Epub ahead of print].

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