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Cited by 13Anesthesia and Sedative AgentsHemodynamic Monitoring and TherapyAnesthesia and Pain Management

Haemodynamic and plasma vasopressin responses during high-dose fentanyl or sufentanil anaesthesia

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Boulton, A. J., Wilson, N., Turnbull, K. W., Yip, R. W.·1986·Canadian Anaesthetists’ Society Journal
DOI 10.1007/bf03010974
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Abstract

This study compared the haemodynamic and arginine vasopressin responses of patients to fentanyl or sufentanil anaesthesia for coronary artery bypass surgery. Fourteen normotensive patients with normal left ventricular function were studied. Patients were induced with fentanyl (N = 7) 37.5 micrograms X kg-1 or sufentanil (N = 7) 7.5 micrograms X kg-1 by intravenous infusion over three minutes. Clinically important chest wall rigidity, bradycardia and recall of intraoperative events did not occur. All of the fentanyl patients became hypertensive after induction and five required vasodilator therapy since they did not respond to boluses of fentanyl (12.5 micrograms X kg-1). Two of these five patients had S-T depression greater than 1 mm. Five patients in the sufentanil group became hypertensive after induction. Four of these patients responded to additional sufentanil (3.75 micrograms X kg-1) while one required vasodilator therapy for concomitant S-T depression. Sufentanil attenuated the increase of arginine vasopressin during cardiopulmonary bypass. Levels of arginine vasopressin in the fentanyl group were significantly higher than those of the sufentanil group during bypass. Levels of AVP after bypass were higher in the sufentanil group. The incidence of hypertension was similar in both groups. The hypertension was more easily treated with sufentanil but concomitant vasodilators (nitroglycerine) were required in both patient groups. Neither fentanyl in doses up to 128 +/- 8.7 micrograms X kg-1 nor sufentanil in doses up to 23 +/- 1.4 micrograms X kg-1 can be used as sole agents for anaesthesia in adult coronary artery bypass patients with good ventricular function when induction times are three minutes and bolus top-up doses are used.

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  • Fentanyl increased AVP release in both surgical patients and healthy volunteers.

    “Fentanyl increased AVP release in both surgical patients (166) and healthy volunteers (167).”

    From Exogenous Opioids and the Human Endocrine System: An Endocrine Society Scientific Statement (2024) · cites this paper as [166]

    The Results report increased plasma AVP in fentanyl-treated surgical patients during cardiopulmonary bypass. The Discussion says AVP remained normal before bypass and describes the rise as occurring during bypass, not as an effect caused by fentanyl itself. The healthy-volunteer claim is attached to citation (167), not this source. (LLM, conf=0.88)

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1 of the 38 references couldn’t be matched to a known paper.

Research works printed but not linked: 4

  1. [15]15. Stanley TH, Berman L, Green O, Robertson D. Plasma eatecholamines and eortisol responses to fentanyl anesthesia for coronary artery operations. Anesthesiology 1980; 53: 250-3.
  2. [21]21. De Castro J, Van de Water A, Wouters L, Xhonneux R, Renaman R, Kay B. Comparative study of cardiovascular, neurological and metabolic side- effects of eight narcotics in dogs. Acta Anaesthesiol Belg 1979; 30: 5-99.
  3. [23]23. Griesemer RW, Moldenhauer CC, Hug Jr CC et al. Sufcntanil anesthesia for aorto-coronary bypass surgery 30 la,g/kg vs 15 Ixg/kg. Anesthesiology 1982; 57: A48.
  4. [25]25. Rosow CE, Philbin DM. Moss J. Keegan CR, Schneider RC. Sufentanil vs fentanyl. Suppression of hemodynamic responses. Anesthesiology 1983; 59: A323.

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Authors
Boulton, A. J., Wilson, N., Turnbull, K. W., & Yip, R. W.
Affiliations
University of British Columbia (CA)
ORCID
Wilson, N.
Venue
Canadian Anaesthetists’ Society Journal
Publisher
Springer Science and Business Media LLC
Published
1986-07
Volume
33
Issue
4
Pages
475-483
ISSN
  • 0832-610X (ISSN-L)
  • 0008-2856
  • 1496-8975
DOI
10.1007/bf03010974
OpenAlex
W1970582420
Semantic Scholar
2339f35588850af8841004dd4f5d966eb2f45972
Cited by
13
References
38
Citations by year
2024: 1 · 2018: 1 · 2014: 1
FWCI
1.25
Type
journal article
Language
en
Open access
Licence
www.springer.com/tdm (tdm)
Locations
  • Canadian Journal of Anesthesia/Journal canadien d anesthésie (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Anesthesia and Sedative Agents
  • Health Sciences › Medicine › Surgery › Hemodynamic Monitoring and Therapy
  • Health Sciences › Medicine › Surgery › Anesthesia and Pain Management
Keywords
fentanyl, sufentanil, vasopressin, hemodynamic response, anesthesia induction, coronary artery bypass grafting, cardiopulmonary bypass, hypertension, ST-segment depression, nitroglycerin, opioid analgesia, vasodilator therapy
MeSH terms
Adult, Aged, Coronary Artery Bypass, Arginine Vasopressin, Blood Proteins, Fentanyl, Hematocrit, Hemodynamics, Humans, Middle Aged, Osmolar Concentration, Water-Electrolyte Balance, Sufentanil

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