Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Twenty patients about to have coronary artery bypass grafts were studied before and after 15 min of 50% nitrous oxide added to either fentanyl (75 micrograms/kg) or enflurane (0.5%) anesthesia. Arterial and central pressures and cardiac output were measured, plus coronary sinus blood flow and arterio-coronary sinus differences in oxygen, hemoglobin, and lactate contents. Fentanyl-N2O and enflurane-N2O both decreased systemic resistance, heart rate, cardiac output, and hence arterial pressure. Stroke work decreased significantly with little or no change in wedge pressure: ventricular function was impaired. Coronary flow and myocardial O2 consumption decreased with fentanyl-N2O. Oxygen extraction increased with enflurane-N2O, as did lactate contents of coronary sinus blood. Hemodynamic depression occurred from the combined effects of nitrous oxide and fentanyl or enflurane. The beta-blocked myocardia of nonstimulated coronary patients were becoming ischemic globally on 50% oxygen, after significant hypotension. From this and other evidence, we conclude that nitrous oxide may not be benign in patients with coronary arterial disease.
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PMID:The effects of nitrous oxide on myocardial metabolism and hemodynamics during fentanyl or enflurane anesthesia in patients with coronary disease. 633 55

This prospective study was designed to evaluate the benefit of a bupivacaine-fentanyl mixture vs bupivacaine alone in epidural anaesthesia for caesarean section. In 10 women, 0.5% bupivacaine (1.18 ml per metamer) was injected in the epidural space. In 20 women, 0.5% bupivacaine (1.06 ml per metamer) was injected by the same route together with fentanyl (1.70 +/- 0.09 micrograms X kg-1). The bupivacaine-fentanyl group showed a significantly shortened onset of analgesia (p less than 0.001), as well as a significant reinforcement of this analgesia graduated from 0 to 4 (p less than 0.01 at 25 min, p less than 0.001 at 75 min and at the maximum of pain, for the two sets of scores). All the Apgar scores were maximal at 5 min. No clinical respiratory depression was observed in either the mothers or the neonates. Fetal and maternal blood concentrations were in favour of respiratory innocuousness of the method (peak fentanyl concentrations: in mothers 1.5 ng X ml-1, in neonates 0.8 ng X ml-1). Fentanyl never induced any significant haemodynamic variations. Pruritus and nausea respectively occurred in six and two patients respectively in the bupivacaine-fentanyl group. In conclusion, in caesarean section, the adjunction of fentanyl to bupivacaine significantly improved analgesia without any clinical respiratory depression both in the mother and the neonate.
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PMID:[Epidural anesthesia using the bupivacaine-fentanyl combination for cesarean section]. 635 72

In rats pretreated with phenobarbital breathing 10% oxygen, subanesthetic doses of halothane, isoflurane, enflurane, thiopental, and fentanyl caused hepatic injury. Because hypoxia per se can produce such injury, we hypothesized that the anesthetic-induced injury resulted from increased hypoxemia secondary to respiratory depression. Male Sprague-Dawley rats were pretreated with phenobarbital; half of the rats were fed and the other half were deprived of food for the 24 h before study. Isoflurane anesthesia was given for the placement of a catheter into the femoral artery. After 1 h of recovery, the rats were exposed to 10% oxygen. Control samples were obtained and halothane, isoflurane, enflurane, thiopental, or fentanyl was administered. Rats given food had higher PaCO2 and lower pH values than starved rats. Also, arterial oxygen saturation (SaO2) tended to be lower in rats given food. At concentrations of 0.15-0.2 MAC or higher, halothane, isoflurane, and enflurane slightly increased PaCO2 values relative to values for a control group exposed only to hypoxia. However, SaO2 and PaO2 did not show significant drug-induced changes. Fentanyl transiently decreased PaO2 and SaO2. Thiopental caused no changes. Thus, we conclude that subanesthetic doses of anesthetics may depress the ventilatory response to hypoxia but that this depression is inconsistent and appears to be too small to cause hepatic damage.
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PMID:Effects of halothane, isoflurane, enflurane, thiopental, and fentanyl on blood gas values in rats exposed to hypoxia. 640 54

The ventilatory response to CO2 after fentanyl 4 micrograms/kg was studied in a group of 10 healthy volunteers of both sexes, aged 20 to 41 years. Following randomization intravenous premedication with either placebo, diazepam 5 mg, droperidol 5 mg or etomidate 10 mg, a total of four test series were performed with each individual in two-week intervals, in order to assess the additive effect of central depressants on opiate-induced respiratory depression. CO2-response curves were obtained during six-minute rebreathing periods up to 60 min after fentanyl. Respiratory frequency as well as slope and position of the curves were compared with pre-drug control values. After fentanyl, CO2-response curves usually showed combined decreases in slope and displacements to the right, which had not completely returned to control levels after one hour. Due to enormous inter- and intra-individual variations, no clearly significant differences could be observed between the premedication groups. Fentanyl plasma concentrations, determined by radioimmunoassay at 1, 3, 6, 10, 20, 30, 45, 60, 75 and 120 min after injection, showed only a poor correlation to the changes of the CO2-response curves. To assess the clinical relevance of results derived from CO2-stimulation studies, the literature is reviewed with respect to the respiratory control system and the interactions of various anaesthetics drugs (including opiate analgesics) with respiratory regulation. The activity of the reticular formation at lower brain stem level seems to be of decisive importance to guarantee adequate ventilation. Despite quite different action sites, most central depressant drugs reduce reticular activity, thus inhibiting compensatory mechanisms which usually help control respiration. CO2-response tests are therefore suggested to be unable to give sufficient clinical information about the respiratory regulation system.
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PMID:[CO2-response curves as a measure of opiate-induced respiratory depression. Studies with fentanyl]. 641 84

Fentanyl or alfentanil (at a dose ten times that of fentanyl) was administered to fifty healthy patients undergoing elective surgery. They were given in a double-blind manner for analgesia in a total intravenous anaesthesia technique to see if differences existed in their respiratory depressant, analgesic or sedative effects. They were combined in the same syringe with etomidate and given by intravenous bolus injection followed by a continuous intravenous infusion. Analgesia was generally adequate for the operations in this study. Respiratory depression (respiratory rate less than ten) lasted about ten minutes after drug administration, ceased in all patients. The return of respiratory rate, consciousness, and psychomotor performance to control was similar in the groups receiving fentanyl or alfentanil. This study showed that alfentanil and fentanyl have equivalent potency and duration of action when used in a ten to one ratio. Furthermore, the technique provided good operating conditions but there was a high incidence of postoperative drowsiness, nausea and vomiting.
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PMID:[Double-blind testing of alfentanyl and fentanyl in total intravenous anesthesia]. 642 98

Two groups of six patients were studied during light general anaesthesia using 2% enflurane and 66% nitrous oxide in oxygen, combined with regional anaesthesia, for hernia and varicose vein surgery. The effects of 3% enflurane were compared with those of fentanyl 0.3 microgram kg-1 i.v., by measuring inspired flow, tidal volume, the timing of inspiration and expiration, and occlusion pressure. Three per cent enflurane decreased ventilation by 12%. Tidal volume, mean inspiratory flow and occlusion pressure were decreased in approximately equal proportions (14, 12 and 8%, respectively). The timing of breathing did not change significantly. Fentanyl did not influence tidal volume. Ventilation was decreased by 28% as a result of a 10% decrease in inspiratory flow and a marked increase in the duration of expiration by 45%. The pattern of activation of the inspiratory muscles, as indicated by occlusion pressure, was changed by fentanyl. During enflurane and nitrous oxide anaesthesia, depression of ventilation by fentanyl or increases in enflurane concentration was not by a common central depressant mechanism.
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PMID:Comparison of decreases in ventilation caused by enflurane and fentanyl during anaesthesia. 661 70

The effects of fentanyl, nitrous oxide, and their combination on myocardial contractility were investigated in the papillary muscle preparation perfused by a donor dog. With a conscious donor, fentanyl infused directly into the arterial blood perfusing the papillary muscle produced a dose-related depression of developed tension. However, blood concentrations of fentanyl required to obtain the depression were in the range of 30-120 micrograms/ml. The ED50 for fentanyl for suppression of papillary muscle contractility was 89 +/- 9 micrograms/ml. When the donor dog was given nitrous oxide (N2O,80% and O2,20%), the developed tension of the papillary muscle decreased 25 +/- 5%. Fentanyl administered during nitrous oxide anesthesia caused a decrease in developed tension that was not significantly different from that obtained without N2O anesthesia (18 +/- 4% vs 13 +/- 4% for 30 micrograms/ml, and 61 +/- 5% vs 58 +/- 4% for 100 micrograms/ml). The results suggest that fentanyl produces a direct negative inotropic effect only in concentrations that are 2-3 orders of magnitude higher than its blood concentrations in fentanyl-induced anesthesia. When fentanyl and nitrous oxide are used together their interaction is not significantly different from additive.
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PMID:Effects of fentanyl and nitrous oxide on contractility of blood-perfused papillary muscle of the dog. 669 64

The efficacy of the neuroleptanalgesic combinations of fentanyl-fluanisone with diazepam; and etorphine-methotrimeprazine, either alone, or with diazepam, was investigated in the rabbit. The effects of these drugs on some cardiovascular variables were studied in chronically catheterized rabbits. Fentanyl-fluanisone and diazepam produced good surgical anaesthesia. Although respiratory depression occurred, this had little effect on blood gas values. In contrast, etorphine-methotrimeprazine and diazepam produced severe respiratory depression with consequent hypercapnia and acidosis.
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PMID:Neuroleptanalgesia in the rabbit. 686 15

Pethidine 50 mg, fentanyl 100 microgram and morphine 2 mg administered to the extradural space, were compared in the treatment of pain following surgery. All three drugs produced a rapid decrease in pain scores as assessed using a visual linear analogue, morphine being the least effective. Fentanyl had a relatively short duration of action (2 h), whereas morphine appeared to be the longest acting. It is suggested that the best relief of pain would be obtained by incremental doses given extradurally. All drugs produced an increase in sedation, but there was no respiratory depression as assessed by PaCO2 measurement.
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PMID:Extradural opioids for postoperative analgesia. A double-blind comparison of pethidine, fentanyl and morphine. 702 74

The effects of fentanyl on arterial pressure and heart rate increases during laryngoscopy and intubation were studied in 45 normotensive, surgical patients, who were randomly allocated to three groups receiving 2 or 6 micrograms/kg of fentanyl or saline in a double-blind fashion before anaesthetic induction with thiopental. Fentanyl supplementation with 2 micrograms/kg significantly attenuated the arterial pressure and heart rate increases during laryngoscopy and intubation, and fentanyl, 6 micrograms/kg, completely abolished these responses. Moreover, fentanyl given during the induction decreased the amount of fentanyl needed during the operation. Respiratory depression was not observed during recovery.
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PMID:Attenuation of the circulatory response to laryngoscopy and intubation by fentanyl. 711 29


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