Journal of Anesthesia

, Volume 11, Issue 4, pp 270–276 | Cite as

Effect of fentanyl on heart rate variability during mechanical ventilation

  • Kei Kohno
  • Junken Koh
  • Yoshihiro Kosaka
Original Articles



This study was performed to investigate the effect of fentanyl alone on heart rate variability (HRV) during mechanical ventilation using power spectral analysis. Arterial baroreceptor reflex was also tested with pharmacological manipulation to assess the contribution of vagal baroreceptor reflex modulation of HRV during fentanyl anesthesia.


Ten patients participated in this study. Electrocardiograms and arterial pressure were recorded prior to and during fentanyl (10 μg·kg−1) and vecuronium (0.2 mg·kg−1) anesthesia, with respiratory rate and tidal volume controlled ventilation. R-R intervals were analyzed by fast Fourier transformation, and changes in low-frequency (LF) and high-frequency (HF) power were compared. Arterial baroreceptor reflex regulation was also tested with administration of nitroglycerin (250 μg) or phenylephrine (250 μg).


HF power was significantly reduced during anesthesia from 3.20±2.93 to 0.46±0.48 ms2·Hz−1·103 (mean±SD,P<0.05). However, LF power did not change despite increases in plasma catecholamine concentrations. The response to phenylephrine was reduced during fentanyl anesthesia from 16.6±5.7 to 9.5±5.4 ms·mmHg−1 (P<0.05), whereas the response to nitroglycerin was not affected.


Our data indicate that fentanyl modulates the respiratory frequency fluctuation of HRV. This is partly caused by the effects of fentanyl on arterial baroreflex sensitivity.

Key words

Fentanyl Heart rate variability Baroreceptor reflex Mechanical ventilation 


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  1. 1.
    Kato M, Komatsu T, Kimura T, Sugiyama F, Nakashima K, Shimada Y (1992) Spectral analysis of heart rate variability during isoflurane anesthesia. Anesthesiology 77:669–674PubMedGoogle Scholar
  2. 2.
    Galletly DC, Westenberg AM, Robinson BJ, Corfiatis T (1994) Effect of halothane, isoflurane and fentanyl on spectral components of heart rate variability. Br J Anaesth 72:177–180PubMedGoogle Scholar
  3. 3.
    Koh J, Brown TE, Beightol LA, Ha CY, Eckberg DL (1994) Human autonomic rhythms: vagal cardiac mechanisms in tetraplegic subjects. J Physiol (Lond) 474:483–495Google Scholar
  4. 4.
    Brown TE, Beightol LA, Koh J, Eckberg DL (1993) Important influence of respiration on human R-R interval power spectra is largely ignored. J Appl Physiol 75:2310–2317PubMedGoogle Scholar
  5. 5.
    Sullebarger JT, Liang CS, Woolf PD, Willick AE, Richeson JF (1990) Comparison of phenylephrine bolus and infusion methods in baroreflex measurements. J Appl Physiol 69:962–967PubMedGoogle Scholar
  6. 6.
    Hirsch JA, Bishop B (1981) Respiratory sinus arrhythmia in humans: how breathing pattern modulates heart rate. Am J Physiol 241:H620-H629PubMedGoogle Scholar
  7. 7.
    Eckberg DL (1983) Human sinus arrhythmia as an index of vagal cardiac outflow. J Appl Physiol 54:961–966PubMedGoogle Scholar
  8. 8.
    Furlan R, Guzzetti S, Crivellaro W, Dassi S, Tinelli M, Baselli G, Cerutti S, Lombardi F, Pagani M, Malliani A (1990) Continuous 24-hour assessment of the neural regulation of systemic arterial pressure and RR variabilities in ambulant subjects. Circulation 81:537–547PubMedGoogle Scholar
  9. 9.
    Kotrly KJ, Ebert TJ, Vucins EJ, Roerig DL, Standricka A, Kampine, JP (1986) Effects of fentanyl-diazepam-nitrous oxide anesthesia on arterial baroreflex control of heart rate in man. Br J Anaesth 58:406–414PubMedGoogle Scholar
  10. 10.
    Ebert TJ, Muzi M (1994) Propofol and autonomic reflex function in humans. Anesth Analg 78;369–375PubMedGoogle Scholar
  11. 11.
    Goldstein DS, Horwitz D, Keiser HR (1982) Comparison of techniques for measuring baroreflex sensitivity in man. Circulation 66:432–439PubMedGoogle Scholar
  12. 12.
    Rouby JJ, Houissa M, Brichant JF, Baron JF, McMillan C, Arthaud M, Amzallag P, Viars P (1987) Effects of high-frequency jet ventilation on arterial baroreflex regulation of heart rate. J Appl Physiol 63:2216–2222PubMedGoogle Scholar
  13. 13.
    Eckberg DL, Wallin BG (1987) Isometric exercise modifies autonomic baroreflex responses in humans. J Appl Physiol 63:2325–2330PubMedGoogle Scholar
  14. 14.
    Thames MD, Kontos HA (1970) Mechanisms of baroreceptor-induced changes in heart rate. Am J Physiol 218:251–256PubMedGoogle Scholar
  15. 15.
    Giudicelli JF, Berdeaux A, Edouard A, Richer C, Jacolot D (1985) The effect of enalapril on baroreceptor mediated reflex function in normotensive subjects. Br J Clin Pharmacol 20:211–218PubMedGoogle Scholar
  16. 16.
    Chen RYZ, Matteo RS, Fan FC, Schuessler GB, Chien S (1982) Resetting of baroreflex sensitivity after induced hypotension. Anesthesiology 56:29–35PubMedGoogle Scholar
  17. 17.
    Fritsch JM, Rea RF, Eckberg DL (1989) Carotid baroreflex resetting during drug-induced arterial pressure changes in humans. Am J Physiol 256:R549-R553PubMedGoogle Scholar
  18. 18.
    Yli-Hankala A, Porkkala T, Kaukinen S, Hakkinen V, Jantti V (1991) Respiratory sinus arrhythmia is reversed during positive pressure ventilation. Acta Physiol Scand 141:399–407PubMedCrossRefGoogle Scholar
  19. 19.
    Lunn JK, Stanley TH, Eisele J, Webster L, Woodward A (1979) High dose fentanyl anesthesia for coronary artery surgery: plasma fentanyl concentrations and influence of nitrous oxide on cardiovascular response. Anesth Analg 58:390–395PubMedCrossRefGoogle Scholar
  20. 20.
    Eckberg DL, Rea RF, Andersson OK, Hedner T, Pernow J, Lundberg JM, Wallin BG (1988) Baroreflex modulation of sympathetic activity and sympathetic neurotransmitters in humans. Acta Physiol Scand 133:221–231PubMedGoogle Scholar
  21. 21.
    Reitan JA, Stengert KB, Wymore ML, Martucci RW (1978) Central vagal control of fentanyl-induced bradycardia during halothane anesthesia. Anesth Analg 57:31–36PubMedGoogle Scholar
  22. 22.
    Laubie M, Schmitt H, Drouillat M (1977) Central sites and mechanisms of the hypotensive and bradycardic effects of the narcotic analgesic agent fentanyl. Arch Pharmacol 296:255–261CrossRefGoogle Scholar
  23. 23.
    Goldberger JJ, Ahmed MW, Parker MA, Kadish AH (1994) Dissociation of heart rate variability from parasympathetic tone. Am J Physiol 266:H2152-H2157PubMedGoogle Scholar
  24. 24.
    Montano N, Ruscone TG, Porta A, Lombardi F, Pagani M, Malliani A (1994) Power spectrum analysis of heart rate variability to assess the changes in sympathovagal balance during graded orthostatic tilt. Circulation 90:1826–1831PubMedGoogle Scholar
  25. 25.
    Appel ML, Berger RD, Saul JP, Smith JM, Cohen RJ (1989) Beat to beat variability in cardiovascular variables: noise or music? J Am Coll Cardiol 14:1139–1148PubMedCrossRefGoogle Scholar
  26. 26.
    Pagani M, Lombardi F, Guzzetti S, Rimoldi O, Furlan R, Pizzinelli P, Sandrone G, Malfatto G, Dell'Orto S, Piccaluga E, Turiel M, Baselli G, Cerrutti S, Malliani A (1986) Power spectral analysis of heart rate and arterial pressure variabilities as a marker of sympatho-vagal interaction in man and conscious dog. Circ Res 59:178–193PubMedGoogle Scholar
  27. 27.
    Saul JP, Rea RF, Eckberg DL, Berger RD, Cohen RJ (1990) Heart rate and muscle sympathetic nerve variability during reflex changes of autonomic activity. Am J Physiol 258:H713-H721PubMedGoogle Scholar

Copyright information

© JSA 1997

Authors and Affiliations

  • Kei Kohno
    • 1
  • Junken Koh
    • 1
  • Yoshihiro Kosaka
    • 2
  1. 1.Department of AnesthesiaKure National HospitalHiroshimaJapan
  2. 2.Department of AnesthesiologyShimane Medical UniversityShimaneJapan

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