Abstract
The pharmacodynamics of fentanyl citrate were studied in two groups of patients. One group underwent surgery with cardiopulmonary bypass (CPB) and the other group had surgery without CPB; the latter group represented the controls. Apneic periods were considerably longer (2.70 ± 0.90 hr) for the CPB patients than for the control patients (1.75 ± 0.75 hr).
The total plasma fentanyl concentration at which apnea ceased was not statistically different between the two groups. Minor differences were attributed to the massive dilution of plasma proteins after the adding of priming fluid to the heart-lung machine.
This prolongation of apnea is of considerable clinical importance because it means that CPB patients must remain mechanically ventilated for longer periods.
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Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Babka R., Pifarré R. Potassium replacement during cardiopulmonary bypass. J Thorac Cardiovasc Surg. 1977 Feb;73(2):212–215. [PubMed] [Google Scholar]
- Bovill J. G., Sebel P. S. Pharmacokinetics of high-dose fentanyl. A study in patients undergoing cardiac surgery. Br J Anaesth. 1980 Aug;52(8):795–801. doi: 10.1093/bja/52.8.795. [DOI] [PubMed] [Google Scholar]
- Downes J. J., Kemp R. A., Lambertsen C. J. The magnitude and duration of respiratory depression due to fentanyl and meperidine in man. J Pharmacol Exp Ther. 1967 Dec;158(3):416–420. [PubMed] [Google Scholar]
- Harper M. H., Hickey R. F., Cromwell T. H., Linwood S. The magnitude and duration of respiratory depression produced by fentanyl and fentanyl plus droperidol in man. J Pharmacol Exp Ther. 1976 Nov;199(2):464–468. [PubMed] [Google Scholar]
- Koska A. J., 3rd, Romagnoli A., Kramer W. G. Effect of cardiopulmonary bypass on fentanyl distribution and elimination. Clin Pharmacol Ther. 1981 Jan;29(1):100–105. doi: 10.1038/clpt.1981.16. [DOI] [PubMed] [Google Scholar]
- Lunn J. K., Stanley T. H., Eisele J., Webster L., Woodward A. High dose fentanyl anesthesia for coronary artery surgery: plasma fentanyl concentrations and influence of nitrous oxide on cardiovascular responses. Anesth Analg. 1979 Sep-Oct;58(5):390–395. [PubMed] [Google Scholar]
- McClain D. A., Hug C. C., Jr Intravenous fentanyl kinetics. Clin Pharmacol Ther. 1980 Jul;28(1):106–114. doi: 10.1038/clpt.1980.138. [DOI] [PubMed] [Google Scholar]
- Miller K. W., Chan K. K., McCoy H. G., Fischer R. P., Lindsay W. G., Zaske D. E. Cephalothin kinetics: before, during, and after cardiopulmonary bypass surgery. Clin Pharmacol Ther. 1979 Jul;26(1):54–62. doi: 10.1002/cpt197926154. [DOI] [PubMed] [Google Scholar]
- Schleimer R., Benjamini E., Eisele J., Henderson G. Pharmacokinetics of fentanyl as determined by radioimmunoassay. Clin Pharmacol Ther. 1978 Feb;23(2):188–194. doi: 10.1002/cpt1978232188. [DOI] [PubMed] [Google Scholar]
- Stoelting R. K., Gibbs P. S., Creasser C. W., Peterson C. Hemodynamic and ventilatory responses to fentanyl, fentanyl-droperidol, and nitrous oxide in patients with acquired valvular heart disease. Anesthesiology. 1975 Mar;42(3):319–324. doi: 10.1097/00000542-197503000-00015. [DOI] [PubMed] [Google Scholar]
