Document Detail


Sympathovagal effects of spinal anaesthesia with intrathecal or intravenous fentanyl assessed by heart rate variability.
MedLine Citation:
PMID:  19226297     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Although many investigators previously reported the sympathovagal effect of spinal anaesthesia, there is no information about the sympathovagal effects of supplementation with fentanyl. The aim of this study was to evaluate the sympathovagal effects of intrathecal or intravenous fentanyl added to spinal anaesthesia. METHODS: One hundred and twenty patients undergoing elective transurethral surgery under spinal anaesthesia were randomly allocated to receive intrathecally either isobaric bupivacaine alone (Group B), bupivacaine supplemented with intrathecal (Group Ft) or with intravenous fentanyl (Group Fv). Heart rate variability was estimated using the MemCalc method (Tarawa, Suwa Trust, Japan) before and after spinal anaesthesia. RESULTS: In all groups, spinal anaesthesia significantly decreased low frequency/high frequency (LF/HF) as a marker of sympathovagal balance. However, patients in Group B with a low block height developed a marked increase in LF/HF after spinal anaesthesia, which was attenuated in Group Ft. Meanwhile, intravenous fentanyl did not attenuate this response. CONCLUSION: We conclude that sympathetic activation observed in patients with a low block height was attenuated by intrathecal fentanyl but not by intravenous fentanyl.
Authors:
Y Fujiwara; S Kurokawa; Y Shibata; Y Asakura; M Harado; T Komatsu
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial     Date:  2009-02-18
Journal Detail:
Title:  Acta anaesthesiologica Scandinavica     Volume:  53     ISSN:  1399-6576     ISO Abbreviation:  Acta Anaesthesiol Scand     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-03-25     Completed Date:  2009-04-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370270     Medline TA:  Acta Anaesthesiol Scand     Country:  England    
Other Details:
Languages:  eng     Pagination:  476-82     Citation Subset:  IM    
Affiliation:
Department of Anaesthesiology, Aichi Medical University, 21 Karimata Yazako, Nagakute, Aichi, Japan. yyoshiff@aichi-med-u.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Analgesics, Opioid / pharmacology*
Anesthesia, Spinal*
Electroencephalography / drug effects
Female
Fentanyl / administration & dosage,  pharmacology*
Heart Rate / drug effects*
Humans
Injections, Intravenous
Injections, Spinal
Male
Middle Aged
Sympathetic Nervous System / drug effects*
Vagus Nerve / drug effects*
Chemical
Reg. No./Substance:
0/Analgesics, Opioid; 437-38-7/Fentanyl

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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