Abstract
Cardiovascular effects of high dose opioid together with low dose inhalant were compared with inhalant alone to determine whether opioid/inhalant techniques were less depressant on the cardiovascular system. The effects of positive pressure ventilation and increasing heart rate to a more physiological level were also studied. Cardiovascular measurements recorded during administration of enflurane at 1.3 minimum alveolar concentration (MAC; 2.89 +/- 0.02%) to spontaneously breathing dogs (time 1) and during controlled ventilation [arterial carbon dioxide tension at 40 +/- 3 mmHg (time 2)] were similar. At time 2, mixed venous oxygen tension and arterial and mixed venous carbon dioxide tensions were significantly decreased, while arterial and mixed venous pH were significantly increased compared to measurements at time 1. After administration of fentanyl to achieve plasma fentanyl concentration of 71.7 +/- 14.4 ng/mL and reduction of enflurane concentration to yield 1.3 MAC multiple (0.99 +/- 0.01%), heart rate significantly decreased, while mean arterial pressure, central venous pressure, stroke index, and systemic vascular resistance index increased compared to measurements taken at times 1 and 2. Pulmonary arterial occlusion pressure was significantly increased compared to measurements taken at time 2. After administration of atropine until heart rate was 93 +/- 5 beats/min (plasma fentanyl concentration 64.5 +/- 13.5 ng/mL) heart rate, mean arterial pressure, cardiac index, oxygen delivery index, and venous admixture increased significantly compared to values obtained at all other times.(ABSTRACT TRUNCATED AT 250 WORDS)
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- Arndt J. O., Mikat M., Parasher C. Fentanyl's analgesic, respiratory, and cardiovascular actions in relation to dose and plasma concentration in unanesthetized dogs. Anesthesiology. 1984 Oct;61(4):355–361. doi: 10.1097/00000542-198410000-00001. [DOI] [PubMed] [Google Scholar]
- Brown B. R., Jr, Crout J. R. A comparative study of the effects of five general anesthetics on myocardial contractility. I. Isometric conditions. Anesthesiology. 1971 Mar;34(3):236–245. doi: 10.1097/00000542-197103000-00007. [DOI] [PubMed] [Google Scholar]
- Copland V. S., Haskins S. C., Patz J. D. Cardiovascular and pulmonary effects of atropine reversal of oxymorphone-induced bradycardia in dogs. Vet Surg. 1992 Sep-Oct;21(5):414–417. doi: 10.1111/j.1532-950x.1992.tb01719.x. [DOI] [PubMed] [Google Scholar]
- De Hert S. G. Study on the effects of six intravenous anesthetic agents on regional ventricular function in dogs (thiopental, etomidate, propofol, fentanyl, sufentanil, alfentanil). Acta Anaesthesiol Belg. 1991;42(1):3–39. [PubMed] [Google Scholar]
- Eisele J. H., Reitan J. A., Torten M., Miller C. H. Myocardial sparing effect of fentanyl during halothane anaesthesia in dogs. Br J Anaesth. 1975 Sep;47(9):937–940. doi: 10.1093/bja/47.9.937. [DOI] [PubMed] [Google Scholar]
- France C. J., Plumer M. H., Eger E. I., 2nd, Wahrenbrock E. A. Ventilatory effects of isoflurane (Forane) or halothane when combined with morphine, nitrous oxide and surgery. Br J Anaesth. 1974 Feb;46(2):117–120. doi: 10.1093/bja/46.2.117. [DOI] [PubMed] [Google Scholar]
- Gabel R. A. Algorithms for calculating and correcting blood-gas and acid-base variables. Respir Physiol. 1980 Dec;42(3):211–232. doi: 10.1016/0034-5687(80)90116-4. [DOI] [PubMed] [Google Scholar]
- Hall R. I., Szlam F., Hug C. C., Jr The enflurane-sparing effect of alfentanil in dogs. Anesth Analg. 1987 Dec;66(12):1287–1291. [PubMed] [Google Scholar]
- Housmans P. R., Murat I. Comparative effects of halothane, enflurane, and isoflurane at equipotent anesthetic concentrations on isolated ventricular myocardium of the ferret. I. Contractility. Anesthesiology. 1988 Oct;69(4):451–463. doi: 10.1097/00000542-198810000-00003. [DOI] [PubMed] [Google Scholar]
- Ilkiw J. E., Haskins S. C., Patz J. D. Cardiovascular and respiratory effects of thiopental administration in hypovolemic dogs. Am J Vet Res. 1991 Apr;52(4):576–580. [PubMed] [Google Scholar]
- Klide A. M. Cardiopulmonary effects of enflurane and isoflurane in the dog. Am J Vet Res. 1976 Feb;37(2):127–131. [PubMed] [Google Scholar]
- Lowenstein E., Philbin D. M. Narcotic "anesthesia" in the eighties. Anesthesiology. 1981 Sep;55(3):195–197. doi: 10.1097/00000542-198109000-00001. [DOI] [PubMed] [Google Scholar]
- MILLER D. E., GLEASON W. L., WHALEN R. E., MORRIS J. J., McINTOSH H. D. Effect of ventricular rate on the cardiac output in the dog with chronic heart block. Circ Res. 1962 Apr;10:658–663. doi: 10.1161/01.res.10.4.658. [DOI] [PubMed] [Google Scholar]
- Michiels M., Hendriks R., Heykants J. A sensitive radioimmunoassay for fentanyl. Plasma level in dogs and man. Eur J Clin Pharmacol. 1977 Oct 14;12(2):153–158. doi: 10.1007/BF00645137. [DOI] [PubMed] [Google Scholar]
- Moon P. F., Ilkiw J. E. Surface-induced hypothermia in dogs: 19 cases (1987-1989). J Am Vet Med Assoc. 1993 Feb 1;202(3):437–444. [PubMed] [Google Scholar]
- Murphy M. R., Hug C. C., Jr The anesthetic potency of fentanyl in terms of its reduction of enflurane MAC. Anesthesiology. 1982 Dec;57(6):485–488. doi: 10.1097/00000542-198212000-00009. [DOI] [PubMed] [Google Scholar]
- Murphy M. R., Olson W. A., Hug C. C., Jr Pharmacokinetics of 3H-fentanyl in the dog anesthetized with enflurane. Anesthesiology. 1979 Jan;50(1):13–19. doi: 10.1097/00000542-197901000-00004. [DOI] [PubMed] [Google Scholar]
- O'Rourke R. A., Bishop V. S. Cardiovascular hemodynamics in the conscious dog. Am Heart J. 1971 Jan;81(1):55–60. doi: 10.1016/0002-8703(71)90054-8. [DOI] [PubMed] [Google Scholar]
- Reddy P., Liu W. S., Port D., Gillmor S., Stanley T. H. Comparison of haemodynamic effects of anaesthetic doses of alphaprodine and sulfentanil in the dog. Can Anaesth Soc J. 1980 Jul;27(4):345–350. doi: 10.1007/BF03007455. [DOI] [PubMed] [Google Scholar]
- Reitan J. A., Stengert K. B., Wymore M. L., Martucci R. W. Central vagal control of fentanyl-induced bradycardia during halothane anesthesia. Anesth Analg. 1978 Jan-Feb;57(1):31–36. doi: 10.1213/00000539-197801000-00007. [DOI] [PubMed] [Google Scholar]
- Ruiz B. C., Tucker W. K., Kirby R. R. A program for calculation of intrapulmonary shunts, blood-gas and acid-base values with a programmable calculator. Anesthesiology. 1975 Jan;42(1):88–95. doi: 10.1097/00000542-197501000-00013. [DOI] [PubMed] [Google Scholar]
- Scott J. C., Ponganis K. V., Stanski D. R. EEG quantitation of narcotic effect: the comparative pharmacodynamics of fentanyl and alfentanil. Anesthesiology. 1985 Mar;62(3):234–241. doi: 10.1097/00000542-198503000-00005. [DOI] [PubMed] [Google Scholar]
- Sebel P. S., Bovil J. G. Cardiovascular effects of sufentanil anesthesia. Anesth Analg. 1982 Feb;61(2):115–119. [PubMed] [Google Scholar]
- Smith T. C. Pharmacology of respiratory depression. Int Anesthesiol Clin. 1971 Fall;9(3):125–143. doi: 10.1097/00004311-197100930-00008. [DOI] [PubMed] [Google Scholar]
- Stanley T. H., Liu W. S., Webster L. R., Johansen R. K. Haemodynamic effects of intravenous methadone anaesthesia in dogs. Can Anaesth Soc J. 1980 Jan;27(1):52–57. doi: 10.1007/BF03006849. [DOI] [PubMed] [Google Scholar]
- Stanley T. H., Webster L. R. Anesthetic requirements and cardiovascular effects of fentanyl-oxygen and fentanyl-diazepam-oxygen anesthesia in man. Anesth Analg. 1978 Jul-Aug;57(4):411–416. doi: 10.1213/00000539-197807000-00008. [DOI] [PubMed] [Google Scholar]
- Steffey E. P., Farver T. B., Woliner M. J. Cardiopulmonary function during 7 h of constant-dose halothane and methoxyflurane. J Appl Physiol (1985) 1987 Oct;63(4):1351–1359. doi: 10.1152/jappl.1987.63.4.1351. [DOI] [PubMed] [Google Scholar]
- Steffey E. P., Gillespie J. R., Berry J. D., Eger E. I., Rhode E. A. Circulatory effects of halothane and halothane-nitrous oxide anesthesia in the dog: spontaneous ventilation. Am J Vet Res. 1975 Feb;36(2):197–200. [PubMed] [Google Scholar]
- Steffey E. P., Howland D., Jr Isoflurane potency in the dog and cat. Am J Vet Res. 1977 Nov;38(11):1833–1836. [PubMed] [Google Scholar]
- Steffey E. P., Howland D., Jr Potency of enflurane in dogs: comparison with halothane and isoflurane. Am J Vet Res. 1978 Apr;39(4):573–577. [PubMed] [Google Scholar]
- Tammisto T., Takki S., Toikka P. A comparison of the circulatory effects in man of the analgesics fentanyl, pentazocine and pethidine. Br J Anaesth. 1970 Apr;42(4):317–324. doi: 10.1093/bja/42.4.317. [DOI] [PubMed] [Google Scholar]
- WARNER H. R., TORONTO A. F. Regulation of cardiac output through stroke volume. Circ Res. 1960 May;8:549–552. doi: 10.1161/01.res.8.3.549. [DOI] [PubMed] [Google Scholar]
- Wagner J. G. A safe method for rapidly achieving plasma concentration plateaus. Clin Pharmacol Ther. 1974 Oct;16(4):691–700. doi: 10.1002/cpt1974164691. [DOI] [PubMed] [Google Scholar]
- Williamson H. A., Cumming D. V., Cobb M. A., Pattison C. W., Yacoub M. H., Jones D. G. Development of an opiate-based anaesthetic technique for use in dogs with cardiomyopathy. Vet Rec. 1991 Nov 2;129(18):398–400. doi: 10.1136/vr.129.18.398. [DOI] [PubMed] [Google Scholar]
- Wong K. C. Narcotics are not expected to produce unconsciousness and amnesia. Anesth Analg. 1983 Jul;62(7):625–626. [PubMed] [Google Scholar]