Document Detail


Haemodynamic response to nitrous oxide during high-dose fentanyl pancuronium anaesthesia.
MedLine Citation:
PMID:  3871999     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Ten patients subjected to coronary by-pass surgery were studied to determine the haemodynamic effects of replacing Fio2 1.0 normoventilation with nitrous oxide in oxygen (Fio2 0.3) after induction of anaesthesia with fentanyl (50 micrograms/kg), flunitrazepam and pancuronium. In all patients the application of N2O decreased systemic arterial pressures by an average of 10% (P less than 0.001), but left pulmonary arterial pressures and systemic vascular resistance unchanged. The slight bradycardia induced was associated with moderate depression of the cardiac index and the left ventricular stroke work index (P less than 0.001) at the time when the rate-pressure product was decreased by 20% (P less than 0.001). The cardiac depression produced by N2O was most prominent in patients with left ventricular wall hypokinesia and an ejection fraction below 55%, in whom the cardiac work index was diminished by 29%. The replacement of oxygen with nitrous oxide in oxygen during high-dose fentanyl-pancuronium anaesthesia seems not to be associated with sympathetic stimulation, and the myocardial depressant effect of N2O should be weighed against the possible reduction in myocardial oxygen consumption with special care in patients with compromised myocardial function.
Authors:
O A Meretoja; O Takkunen; H Heikkilä; U Wegelius
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Acta anaesthesiologica Scandinavica     Volume:  29     ISSN:  0001-5172     ISO Abbreviation:  Acta Anaesthesiol Scand     Publication Date:  1985 Jan 
Date Detail:
Created Date:  1985-03-26     Completed Date:  1985-03-26     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370270     Medline TA:  Acta Anaesthesiol Scand     Country:  DENMARK    
Other Details:
Languages:  eng     Pagination:  137-41     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Anesthesia, General*
Blood Pressure / drug effects
Coronary Artery Bypass
Depression, Chemical
Female
Fentanyl*
Heart Rate / drug effects
Hemodynamics / drug effects*
Humans
Intraoperative Care
Male
Middle Aged
Myocardium / metabolism
Nitrous Oxide / pharmacology*
Oxygen Consumption / drug effects
Pancuronium*
Preanesthetic Medication
Stroke Volume / drug effects
Vascular Resistance / drug effects
Chemical
Reg. No./Substance:
0/Pancuronium; 10024-97-2/Nitrous Oxide; 437-38-7/Fentanyl

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