Urine catecholamine excretion after large doses of fentanyl, fentanyl and diazepam and fentanyl, diazepam and pancuronium

  • Wen-Shin Liu
  • Arun V. Bedwai
  • Judd K. Lunn
  • Theodore H. Stanley
Article

Summary

The effects of fentanyl (0.5 mg/kg iv), fentanyl with diazepam (1 mg/kg iv) and fentanyl, diazepam and pancuronium (0.1 mg/kg iv) on heart rate (HR), mean arterial blood pressure (BP), cardiac output (Qt), urine flow rate and urine epinephrine and norepinephrine excretion were determined in nine dogs. Fentanyl did not significantly change Qt or BP but did reduce HR and urine flow rate ( P < 0.05). Urine epinephrine and norepinephrine excretion rates were significantly increased by fentanyl ( P < 0.05 ). Diazepam caused no significant further changes in Qt, BF or HR 30 minutes after administration, but urine epinephrine and norepinephrine excretion rates were reduced to control (pre-fentanyl ) levels. Addition of pancuronium after fentanyl and diazepam increased urine flow rate to prefentanyl levels and elevated Qt, BP and HR above controls but produced no significant change in urine epinephrine or norepinephrine excretion. These data suggest that fentanyl increases catecholamine blood levels and imply that the latter may be one mechanism by which cardiovascular dynamics are maintained stable during fentanyl anaesthesia. Our findings also demonstrate that cardiovascular stimulation after pancuronium is not associated with increased urinary catecholamine excretion.

Résumé

Le Fentanyl à forte dose, associé au Diazepam et au Pancuronium, affecte peu la dynamique cardio-vasculaire et, pour cette raison, cette association a été suggérée chez les grands malades. On ne connaît pas ľinfluence de cette technique sur les taux sanguin et urinaire de catécholamines.

Nous avons donc étudié les effets du Fentanyl (0.5 mg/kilo i.v. ), du Fentanyl associé au Diazepam ( 1 mg/kilo i.v. ), et de ľaddition de Pancuronium ( 0.1 mg/kilo i.v. ) aux deux autres, ceci chez neuf chiens. Ľon a également déterminé les variations de la fréquence cardiaque, de la pression artérielle moyenne, et le débit cardiaque.

Le Fentanyl n’a pas modifié significativement la pression moyenne, ni le débit cardiaque, mais il a diminué ( p < 0.5 ) la fréquence cardiaque et le débit urinaire. Les taux ďEpinéphrine et de Norépinéphrine urinaires ont été significativement élevés (p < 0.05) par le Fentanyl.

Trente minutes après son administration, ľaddition de Diazepam n’avait pas modifié la fréquence, la pression moyenne et le débit cardiaque, mais les taux ďexcrétion urinaire ďEpinéphrine et de Norépinéphrine étaient redescendus aux niveaux observés avant ľadministration de Fentanyl. Enfin, ľaddition de Pancuronium à la suite du Fentanyl et du Diazepam augmentait le débit urinaire aux chiffres observés avant ľadministration de Fentanyl, élevait la pression moyenne, la fréquence et le débit cardiaques, mais n’amenait pas de modification dans ľexcrétion urinaire ďEpinéphrine et de Norépinéphrine.

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Copyright information

© Canadian Anesthesiologists 1977

Authors and Affiliations

  • Wen-Shin Liu
    • 1
  • Arun V. Bedwai
    • 1
  • Judd K. Lunn
    • 1
  • Theodore H. Stanley
    • 1
  1. 1.Department of AnesthesiologyUniversity of Utah College of MedicineSalt Lake City

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