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)

We evaluated in human monocytes the effect of high doses of alfentanyl on the expression of vimentin filaments, the phagocytic activity and the membrane display of HLA-DR molecules in the subjects undergoing surgery. The study was performed on 30 patients, ASAI-II. The patients received 100 mcg/kg i.v. of Alfentanil and the maintenance of anaesthesia was made with Alfentanil (2-3 mcg/kg/min.). The patients were randomized in two groups. The patients were ventilated with N2O:O2 (1:1) (Group I) or air: O2 (1:1) (Group II). After surgery, all patients of the Group II received Naloxone (0.2-0.4 mg). Central venous blood samples were obtained before induction, one and two hours after induction of anaesthesia and at the end of surgery. Separation of monocytes was performed according to Boyum technique. CD35 and HLA-DR molecules and vimentin filaments were studied by indirect immunofluorescence method using monoclonal antibodies. Percentage of positive cells were read with a cytofluorometer. The phagocytic function of monocytes was determined by ingestion of latex particles. Cortisol and ACTH plasma levels were determined by RIA. High doses of Alfentanyl depress phagocytic function and membrane display of CD35 and HLA-DR molecules in monocyte and induce marked changes in the organization of vimentin filaments in these cells in patients undergoing surgery. This monocytic depression was more marked in the patients ventilated with N2O. In our results there was uninhibition of ACTH and cortisol plasma levels responses to surgical stress by Alfentanil administration. Since the effects of Alfentanil were reversed by Naloxone, an opioid receptor mechanism seems to mediate these events.
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PMID:[Depression of the mononuclear phagocyte system caused by high doses of narcotics]. 133 12

Ondansetron is a selective 5-hydroxytryptamine type 3 receptor antagonist effective as an antiemetic in patients experiencing post-operative or cancer chemotherapy-induced nausea and vomiting. Currently, no information is available regarding the interaction of ondansetron with opioids, although a serotonin antagonist might be expected to modify some opioid actions. This study was designed to measure the effects of ondansetron on alfentanil-induced ventilatory depression and sedation in healthy male volunteers. Ventilatory drive (measured as the end-tidal CO2 necessary to produce a minute ventilation of 15 l/min) was determined in 29 subjects using a modification of the Read rebreathing technique. Sedation was measured by asking the subjects to complete visual analog scales. Alfentanil was administered as a bolus (5 micrograms/kg) followed by a continuous infusion (0.25-0.75 micrograms.kg-1.min-1) for at least 90 min. Study medication (ondansetron 8 or 16 mg or vehicle placebo) was then administered in a randomized, double-blind manner, and the alfentanil was infused for an additional 15 min. Measurements of ventilatory drive and sedation were made at baseline, during alfentanil infusion, after study medication, and at 30-min intervals after alfentanil was discontinued. Alfentanil produced significant ventilatory depression (P less than 0.001) and sedation (P less than 0.001) in all three groups. Neither placebo nor ondansetron produced further change in the intensity of either alfentanil effect. After discontinuation of the opioid, both ventilatory depression and sedation decreased, and the rate of recovery was not significantly different between groups. The data indicate that alfentanil-induced sedation and ventilatory depression are not significantly affected by the subsequent administration of ondansetron.
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PMID:Ondansetron does not affect alfentanil-induced ventilatory depression or sedation. 138 67

In addition to producing antinociception and mild sedation, opiates diminish spontaneous movement and produce muscle rigidity. Examination of the relationship between different opiate effects may lead to a better understanding of the mechanism and sites of action of opiate anesthesia. Previous studies have compared the dose-effect relationships for morphine and fentanyl between antinociception and loss of righting reflex. However, neither muscle rigidity nor lack of spontaneous movement (as measured by catalepsy) has been fully examined or directly compared with either antinociception or loss of righting reflex. This study, therefore, compared five clinically relevant opiate endpoints (antinociception, muscle rigidity, catalepsy, loss of righting reflex, and respiratory depression) using the mu-selective agonist alfentanil in the spontaneously ventilating rat. Rats were randomized to receive alfentanil (0-500 micrograms/kg) subcutaneously. For muscle rigidity, 59 rats had electromyographic activity measured with percutaneous hindlimb electrodes. After alfentanil injection, electromyographic data were recorded for 60 min. For antinociception and catalepsy, 49 rats were studied for 120 min after alfentanil. Catalepsy was measured from the time the rat's forelimbs were placed on a 10-cm-high bar until either limb was removed. Antinociception was studied by measuring tail-flick response to hot (55 degrees C) water. For righting reflex, 40 rats were studied for 120 min. Alfentanil-induced respiratory depression was assessed in 40 rats with indwelling tail arterial catheters. Alfentanil was administered after baseline arterial blood gas measurements, and then additional samples were obtained for 45 min. For each effect, data were converted into quantal responses and were then transformed to probit-log dose-response curves for analysis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Elucidation of dose-effect relationships for different opiate effects using alfentanil in the spontaneously ventilating rat. 160 89

The pressor response to intubation is known to be exaggerated in patients with gestational proteinuric hypertension (GPH). The effect of pretreatment with lignocaine 1.5 mg kg-1, magnesium sulphate 40 mg kg-1 or alfentanil 10 micrograms kg-1 on this pressor response was studied in 69 patients with moderate to severe GPH. Systolic arterial pressure exceeded baseline values for the first 5 min after tracheal intubation in the lignocaine group, with a peak increase of 31.6 (SEM 3.6) mm Hg at 2 min after intubation, but no mean increase in pressure occurred in the two other groups. Following intubation, six of 24 mothers in the alfentanil group, six of 21 in the lignocaine group and one of 24 in the magnesium group (P less than 0.05) exhibited a systolic arterial pressure (SAP) greater than 180 mm Hg sustained for 2 min or more. Alfentanil caused the least change in heart rate, but resulted in significant fetal depression.
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PMID:Attenuation of the pressor response to tracheal intubation in hypertensive proteinuric pregnant patients by lignocaine, alfentanil and magnesium sulphate. 181 24

The purpose of this retrospective study was to evaluate the combined use of intravenous analgesia, with a potent opiate alone, supplemented by local anaesthesia as an alternative to general anaesthesia for medically compromised patients. Sixty-two in-patients, aged between 32 and 80 years, with an ASA physical status of III and IV, were involved in this study. The local anesthetic used was 4% articain with epinephrine (1:200,000) and narcotic analgesics were Fentanyl or Alfentanil. Surgical procedures included multiple dental extractions, cystectomy and the removal of impacted teeth. All patients completed the surgery without deeper anaesthesia and mostly enjoyed a comfortable intraoperative period. Only one respiratory depression was observed, but quickly reversed. Other adverse effects were few and without consequences, hemodynamic changes remained in tolerable limits. In conclusion this anaesthetic technique can be a suitable alternative to general anaesthesia in oral surgery for high-risk patients.
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PMID:Local anaesthesia with intravenous analgesia as an alternative to general anaesthesia for medically compromised patients undergoing oral surgery. A retrospective study of sixty-two cases. 183 35

We present the case of a parturient with severe mitral stenosis and pulmonary hypertension who received general anaesthesia using alfentanil for urgent Caesarean section. Alfentanil promoted haemodynamic stability and allowed immediate postoperative extubation. Epidural morphine provided postoperative analgesia. This combination permitted early ambulation and prevention of thromboembolism. A disadvantage of this technique, neonatal respiratory depression, was promptly reversed with a single dose of naloxone. The anaesthetic management of mitral stenosis in pregnancy is discussed and the neonatal pharmacokinetics of maternally administered alfentanil are presented.
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PMID:Alfentanil for urgent caesarean section in a patient with severe mitral stenosis and pulmonary hypertension. 211 2

The effect on invasive and non-invasive oxygen, carbon dioxide and haemoglobin saturation measures of two repeated doses of alfentanil 0.5 microgram/kg were tested in 16 patients scheduled for elective cataract surgery under periocular anaesthesia. Alfentanil caused an acute respiratory depression, which was demonstrated as increased levels of arterial and end-tidal carbon dioxide and concomitant decrease in arterial and end-tidal oxygen levels as well as decreased arterial blood saturation and pulse oximeter readings. There was a good correlation between the non-invasive respiratory parameters and blood gas levels, as well as between pulse oximetry numbers and oxygen saturation of arterial blood. Therefore, hypoventilation and concurrent hypoxaemia can be predicted by monitoring end-tidal CO2.
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PMID:Comparison of non-invasive respiratory and arterial blood gas analysis. A recovery room study on acute respiratory depression. 212 59

Intubation conditions and pressor response were assessed in 30 healthy patients undergoing awake nasotracheal intubation. The patients were premedicated with peroral diazepam. All the patients were sedated with intravenous diazepam 0.1 mg/kg. Alfentanil 20 micrograms/kg or saline was administered in a double-blind fashion. Alfentanil caused moderate respiratory depression but significantly improved conditions for fiberoscopy. In the control group, arterial pressures and heart rate increased significantly immediately after tracheal intubation. These responses were attenuated by alfentanil.
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PMID:Effects of alfentanil on the responses to awake fiberoptic nasotracheal intubation. 230 44

Several cases of recurrent respiratory depression progressing to apnoea and unconsciousness after apparent recovery from sufentanil have been reported recently. Alfentanil has the shortest elimination half-time of the narcotics used in anaesthesia, suggesting that it should be the least likely to cause postoperative respiratory depression. A case of recurrent unconsciousness and respiratory arrest after apparent recovery from alfentanil-isoflurane-nitrous oxide anaesthesia is reported. A total dose of 137 micrograms.kg-1 alfentanil was given over a 3.25-hr period to a 45-year-old female undergoing partial gastrectomy. Naloxone, 0.16 mg IV, rapidly restored spontaneous ventilation and consciousness. This case demonstrates that apnoea and unconsciousness can also recur after apparent recovery from alfentanil. Recovery room personnel should be aware of this phenomenon. Earlier detection may permit treatment before apnoea occurs. Patients given narcotic-supplemented anaesthesia should be monitored by capnography and/or pulse oximetry in the early postoperative period.
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PMID:Apnoea and unconsciousness after apparent recovery from alfentanil-supplemented anaesthesia. 231 Nov 53

Alfentanil was used as an adjuvant to midazolam for analgesia in thirty outpatients undergoing colonoscopy. A similar group of thirty outpatients received fentanyl. The operating conditions and recovery times of the two groups were compared. Alfentanil usage resulted in better operating conditions. Recovery time was similar. Patient acceptance was high. No patient suffered respiratory depression during or after the procedure.
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PMID:Pain relief for outpatient colonoscopy: a comparison of alfentanil with fentanyl. 226 38


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