JOURNAL HOME CME HOME THIS MONTH PAST ISSUES ETOC COLLECTIONS
AUTHORS REVIEWERS EDITORIAL BOARD FEEDBACK RSS HELP
A&A International Anesthesia Research Society
QUICK SEARCH:   [advanced]


     

Anesth Analg 1981; 60:563-568
© 1981 International Anesthesia Research Society
This Article
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a colleague
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Hicks, H. C.
Right arrow Articles by Yhap, E. O.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Hicks, H. C.
Right arrow Articles by Yhap, E. O.

Cardiovascular Effects of and Catecholamine Responses to High Dose Fentanyl-O2 for Induction of Anesthesia in Patients with Ischemic Coronary Artery Disease

Henry C. Hicks, MD, Alan G. Mowbray, MD, and Edgar O. Yhap, MD

Received from Anesthesia-Operative Service, Department of Surgery, Letterman Army Medical Center, Presidio of San Francisco, California.

Abstract

Cardiovascular effects of high dose fentanyl-O2 during induction of anesthesia for coronary artery bypass surgery were studied in 10 A.S.A. class III patients. All patients had normal left ventricular function at cardiac catheterization and had ejection fractions greater than or equal to 0.60. Cardiovascular profiles, obtained after the stepwise intravenous administration of 15, 30, and 50 µg/kg of fentanyl and compared with base line values, showed statistically significant decreases in cardiac and left ventricular stroke work indices. Plasma samples were assayed radioenzymatically for norepinephrine, epinephrine, and dopamine. Plasma norepinephrine levels were elevated significantly after 15 µg/kg, remained elevated after 30 µg/kg, but after 50 µg/kg declined toward base line values. Mixed venous oxygen content decreased significantly after 50 µg/kg of fentanyl. From these data, it is concluded that although high dose fentanyl-O2 is suitable for induction of anesthesia in patients with ischemic coronary artery disease, it may be associated with decreasing left ventricular function at doses in excess of 30 µg/kg. The decrease in mixed venous oxygen content excludes decreasing metabolic demands as a sole reason for decreases in cardiac and left ventricular stroke work indices. The catecholamine response observed suggests either a dose- or time-related effect of fentanyl or the "stress" of induction of anesthesia.

Key Words: ANALGESICS: fentanyl • ANESTHETICS, Intravenous fentanyl • SYMPATHETIC NERVOUS SYSTEM: catecholamines.






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 1981 by the International Anesthesia Research Society.