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Studies of fentanyl-supplemented anaesthesia: Effect of naloxone on the circulation and respiration

  • J. G. Purdell-Lewis
Article

Abstract

Ninety-nine unselected patients were given a standardized general anaesthetic with fentanyl 1.5 jag · kg-1 every 30 minutes and were randomly divided into three equal Groups: Group I patients received naloxone 0.1 mg, Group II naloxone 0.2 mg, and Group III naloxone 0.4 mg, at the end of operation and after the reversal of neuromuscular blockade. After administration of naloxone systolic blood pressure increased by 4, 8 and 7 per cent and mean arterial blood pressure increased by 3, 8 and 8 per cent in Groups I, II and III respectively; heart rate increased by 4, 11 and 8 per cent and rate-pressure product increased by 7, 18 and 15 per cent in Groups I, II and III respectively. Tidal volume increased by 97, 101 and 95 per cent and minute volume increased by 122, 164 and 143 per cent in Groups I, II and III respectively after naloxone. Forty-nine percent of patients had a tidal volume of less than 5 ml · kg-1 ora minute volume of less than 50 ml · kg-1 before administration of naloxone; after naloxone three patients in Group I (naloxone 0.1 mg) had a tidal volume of less than 5 ml · kg-1 and no patient had a respiratory minute volume of less than 50 ml · kg-1. It is concluded that under the conditions of this study naloxone 0.1 mg is adequate to reverse the respiratory depressant effect of fentanyl in the majority of cases.

Keywords

Fentanyl Tidal Volume Naloxone Neuromuscular Blockade Adequate Ventilation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Résumé

Quatre-vingt-dix-neuf patients non sélectionnés ont reçu une anesthésie générale au protoxyde ďazote-oxygène additionné aux 30 minutes ďune dose de fentanyl à raison de 1.5 μg · kg-1 Ces patients ont été divisés au hasard en trois groupes. En fin ďintervention et après que le blocage neuromusculaire ait été renversé, les patients du groupe I ont reçu 0.1 mg de naloxone, ceux du groupe II 0.2 mg et ceux du groupe III 0.4 mg du même agent. On a observé, après cette injection, des élévations des pressions artérielles systoliques de 4, 8 et 7 pour cent, et de 3, 8 et 8 pour cent dans le cas des pressions artérielles moyennes chez les patients des groupes I, II et III respectivement; la fréquence cardiaque s’est élevée de 4, 11 et 8 pour cent et le produit fréquence-pression s’est de même élevé de 7, 18 et 15 pour cent chez les malades des groupes I, II et III. Toujours dans le même ordre, le volume courant s’est élevé de 97, 101 et 95 pour cent, alors que le volume minute augmentait de 122, 164 et 143 pour cent après naloxone.

Chez 49 pour cent des patients, on a observé un volume courant inférieur à 5 ml · kg-1 ou un volume minute de moins de 50 ml · kg-1 avant ľinjection de naloxone; après ľinjection, trois patients du groupe I (dose de 0.1 mg · kg-1) présentaient encore un volume courant inférieur à 5 ml · kg-1’ et aucun patient ne présentait un volume minute inférieur à 50 ml · kg-1.

Il est conclu que dans des conditions analogues à celles de cette étude, une dose de naloxone de 0.1 mg · kg-1 est adéquate dans la majorité des cas pour renverser les effets dépresseurs respiratoires du fentanyl.

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Copyright information

© Canadian Anesthesiologists 1980

Authors and Affiliations

  • J. G. Purdell-Lewis
    • 1
  1. 1.Department of AnaesthesiaUniversity of Alberta HospitalEdmonton

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