{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T07:05:56Z","timestamp":1784099156811,"version":"3.55.0"},"reference-count":37,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Fentanyl-induced cough (FIC) is a common adverse reaction during anesthetic induction. Although usually transient, FIC may increase intracranial, intraocular, and intra-abdominal pressures and cause serious complications. Tegileridine (SHR8554), a G-protein-biased \u03bc-opioid receptor agonist, may modulate opioid-induced cough, although the underlying mechanism remains unproven. This study evaluated whether tegileridine pretreatment reduces FIC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In this prospective, randomized, double-blind, placebo-controlled trial, 232 adults scheduled for elective surgery under general anesthesia were screened, and 216 were randomized to receive tegileridine 0.5 mg diluted to 5 mL (Group T) or 5 mL normal saline (Group C). The study drug was injected intravenously over 10 s immediately before rapid fentanyl injection (4 \u03bcg\u00b7kg\n                      <jats:sup>\u22121<\/jats:sup>\n                      over 2 s). The primary endpoint was FIC incidence within 2 min after fentanyl injection. Secondary endpoints included cough severity, hemodynamic changes, and adverse events.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      FIC occurred in 31 of 108 patients in Group C and 12 of 108 patients in Group T (28.7% vs. 11.1%; \u03c7\n                      <jats:sup>2<\/jats:sup>\n                      = 10.48,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.001). Tegileridine reduced the relative risk of FIC by 61.3% (RR, 0.39; 95% CI, 0.21\u20130.71), with an absolute risk reduction of 17.6% and a number needed to treat of 5.7. Cough severity was lower in Group T (\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001). MAP and HR changes did not differ significantly, and immediate adverse events were uncommon.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Tegileridine 0.5 mg pretreatment reduced the incidence and severity of FIC without evidence of immediate hemodynamic instability. Further active-comparator, dose-finding, and broader safety studies are required before routine clinical adoption.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.chictr.org.cn\/searchproj.html<\/jats:ext-link>\n                      , identifier: ChiCTR2500115512.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1866291","type":"journal-article","created":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T06:10:52Z","timestamp":1784095852000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of tegileridine pretreatment on fentanyl-induced cough during general anesthesia induction: a randomized controlled trial"],"prefix":"10.3389","volume":"13","author":[{"given":"Shaojie","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Weifang People's Hospital","place":["Weifang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Weifang People's Hospital","place":["Weifang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yajuan","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Weifang People's Hospital","place":["Weifang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongyi","family":"Xiao","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Weifang People's Hospital","place":["Weifang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yonghao","family":"Hou","sequence":"additional","affiliation":[{"name":"Department of Surgery, Johns Hopkins University School of Medicine","place":["Baltimore, MD, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huiwen","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Weifang Maternal and Child Health Hospital","place":["Weifang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,15]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"747","DOI":"10.1007\/s40265-017-0727-z","article-title":"Fentanyl formulations in the management of pain: an update","volume":"77","author":"Schug","year":"2017","journal-title":"Drugs."},{"key":"B2","doi-asserted-by":"publisher","first-page":"e161218","DOI":"10.5812\/aapm-161218","article-title":"Prevention of fentanyl 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