Abstract
The purpose of this study was to determine whether centrally mediated sympathetic tone exerts compensatory effects on nitrous oxide-induced myocardial depression during highdose fentanyl anaesthesia. The cardiovascular responses to 60 minutes of nitrous oxide administration after fentanyl, 100 μg · kg-1, were examined in 18 dogs with or without autonomic blockade induced by hexamethonium. Decreases of cardiac output and left ventricular stroke work were significantly greater in dogs with autonomic blockade (n = 9) by about 20 per cent of baseline values than in dogs without autonomic blockade (n = 9) at 30, 45, and 60 min. Similarly, left ventricular dP/dt was reduced more in dogs with autonomic blockade than in dogs without autonomic blockade, but this difference was only significant at the 60-min period. It is concluded that the sympathetic nervous system provides partial compensation for myocardial depression induced by nitrous oxide in the presence of highdose fentanyl, suggesting that large doses of fentanyl do not ablate the centrally mediated sympathomimetic effects of nitrous oxide.
Résumé
Le but de cette étude était de déterminer si la réponse sympathique d’origine centrale amène une compensation sur la dépression myocardique induite par le protoxyde d’azote lors d’une anesthésie à haute dose de fentanyl. Les réponses cardiovasculaires après administration de 60 minutes de protoxyde d’azote après 100 μg · kg-1 de fentanyl, ont été examinées chez 18 chiens avec ou sans blocage du système sympathique induit par l’hexamethonium. La diminution du débit cardiaque, du travail du ventricule gauche étaient significativement plus grands chez les chiens ayant eu un blocage du système autonome (n = 9). Cette augmentation se chiffrait à 20 pour cent des valeurs de contrôle comparativement à celles des chiens qui n’ont pas eu de blocage du système autonome (n = 9) à 30, 45, et 60 minutes. Egalement le dP/dt du ventricule gauche était moindre chez les chiens ayant un blocage du système autonome comparativement aux chiens qui n’ont pas eu de blocage. Mais cette différence n’était significative qu’après 60 minutes. On conclut que le système nerveux sympathique amène une compensation partielle de la dépression myocardique induite par le protoxyde dazote en presence de fortes doses de fentanyl suggérant que de larges doses de fentanyl n’abolissent pas la reponse sympathomimétique d’origine centrale produite par le protoxyde dazote.
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Anzai, Y., Nishikawa, T. & Namiki, A. Attenuated sympathetic tone augments nitrous oxide-induced myocardial depression during high-dose fentanyl anaesthesia in dogs. Can J Anaesth 37, 245–249 (1990). https://doi.org/10.1007/BF03005477
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DOI: https://doi.org/10.1007/BF03005477