Hemodynamic and ventilatory responses to fentanyl, fentanyl-droperidol, and nitrous oxide in patients with acquired valvular heart disease

• Published in: Anesthesiology (Philadelphia) 1975-03, Vol.42 (3), p.319-324
• Main Authors: Stoelting, R K, Gibbs, P S, Creasser, C W, Peterson, C
• Format: Article
• Language: English
• Subjects: Adult; Anesthesia, Inhalation; Anesthesia, Intravenous; Blood Pressure - drug effects; Carbon Dioxide - blood; Cardiac Output - drug effects; Central Venous Pressure - drug effects; Droperidol - administration & dosage; Droperidol - pharmacology; Fentanyl - administration & dosage; Fentanyl - pharmacology; Heart Rate - drug effects; Heart Valve Diseases - physiopathology; Heart Valve Diseases - surgery; Heart Valves - surgery; Hemodynamics - drug effects; Humans; Middle Aged; Morphine - pharmacology; Nitrous Oxide - administration & dosage; Nitrous Oxide - pharmacology; Oxygen - blood; Respiration - drug effects; Space life sciences; Vascular Resistance - drug effects
• ISSN: 0003-3022
• DOI: 10.1097/00000542-197503000-00015

Fentanyl (10 mug/kh) or fentanyl (10 mug/kg) plus droperidol (100 mug/kg) administered intravenously during 20 minutes to adult patients with acquired valvular heart disease produced minimal circulatory changes. The trend during drug infusion was for mean arterial pressure and systemic vascular resistance to decrease, and for cardiac index and stroke volume index to increase without change in heart rate. Central venous pressure increased during drug infusion (P less than 0.05) but decreased to awake levels following controlled ventilation and skeletal-muscle paralysis, probably reflecting thoracoabdominal-muscle rigidity rather than a circulatory response. Hypoventilation during drug infusion necessitated assisted or controlled ventilation, with or without skeletal muscle paralysis, in 14 of 16 patients. Addition of 60 per cent nitrous oxide following fentanyl or fentanyl-droperidol infusion significantly decreased mean arterial pressure, heart rate, and cardiac index. All circulatory changes were similar in direction and extent to those previously found during morphine-nitrous oxide anesthesia. (Key words: Anesthetics, intravenous, fentanyl; Anesthetics, gases, nitrous oxide; Heart, effect of fentanyl, dorperidol, and nitrous oxide.).