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

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 resi...

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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
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container_title Anesthesiology (Philadelphia)
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creator Stoelting, R K
Gibbs, P S
Creasser, C W
Peterson, C
description 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.).
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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. 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dosage</topic><topic>Nitrous Oxide - pharmacology</topic><topic>Oxygen - blood</topic><topic>Respiration - drug effects</topic><topic>Space life sciences</topic><topic>Vascular Resistance - drug effects</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Stoelting, R K</creatorcontrib><creatorcontrib>Gibbs, P S</creatorcontrib><creatorcontrib>Creasser, C W</creatorcontrib><creatorcontrib>Peterson, C</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Anesthesiology (Philadelphia)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Stoelting, R K</au><au>Gibbs, P S</au><au>Creasser, C W</au><au>Peterson, C</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hemodynamic and ventilatory responses to fentanyl, fentanyl-droperidol, and nitrous oxide in patients with acquired valvular heart disease</atitle><jtitle>Anesthesiology (Philadelphia)</jtitle><addtitle>Anesthesiology</addtitle><date>1975-03</date><risdate>1975</risdate><volume>42</volume><issue>3</issue><spage>319</spage><epage>324</epage><pages>319-324</pages><issn>0003-3022</issn><abstract>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. 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ispartof Anesthesiology (Philadelphia), 1975-03, Vol.42 (3), p.319-324
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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
title Hemodynamic and ventilatory responses to fentanyl, fentanyl-droperidol, and nitrous oxide in patients with acquired valvular heart disease
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