Effects of high-dose fentanyl on fluid and vasopressor requirements after cardiac surgery

Tuman, Kenneth J.; Keane, D. M.; Spiess, Bruce D.; McCarthy, Robert J.; Silins, Astrida I.; Ivankovich, Anthony D.

doi:10.1016/0888-6296(88)90221-9

Cited by 18 publications

(2 citation statements)

References 14 publications

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“…Tuman et al 24 compared diazepamketamine anaesthesia with high-dose fentanyl in patients premedicated with diazepam, who underwent cardiac surgery. They found the haemodynamic changes associated with induction, intubation, and sternotomy to be comparable with those associated with high-dose fentanyl.…”

Section: Discussionmentioning

confidence: 99%

Oral clonidine premedication attenuates the haemodynamic effects associated with ketamine anaesthetic induction in humans

Doak

Duke

1993

Can J Anaesth

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Induction of anaesthesia is often associated withAccepted for publication 29th March, 1993. in those patients given C preoperatively than in those who received either D or P. The peak increase in mean blood pressure was 39O/o (C) The ideal intravenous induction agent should have a rapid onset and short duration of action while producing ade-CAN J ANAESTH 1993 / 40:7 / pp612-8 ~ersus 70% (D) and 55% (P) (P < 0.01). Heart rate increased by a maximum of 20% (C) versus 41% (D) and 46% (P) (P < 0.01). We conclude that oral clonidine attenuates the hyperdynamic effects of anaesthetic induction with iv ketamine. L'induction de l'anesth~sie s'accompagne souvent de changements indksirables de la tension art~rielle et

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Section: Discussionmentioning

confidence: 99%

Oral clonidine premedication attenuates the haemodynamic effects associated with ketamine anaesthetic induction in humans

Doak

Duke

1993

Can J Anaesth

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“…Nevertheless, in a randomized prospective study comparing highdose fentanyl with ketamine diazepam anesthesia for singlevalve replacement and myocardial revascularization, it was reported that ketaminediazepam anesthesia was associated with decreased postoperative requirements for fluids and vasopressor drugs, decreased pulmonary shunt frac tion, and shorter ICU stay. 39 Both techniques resulted in a stable intraoperative hemodynamic picture.…”

Section: Cardiothoracic Anesthesiamentioning

confidence: 94%

Pharmacological Aspects and Potential New Clinical Applications of Ketamine: Reevaluation of an Old Drug

Aroni

Iacovidou

Dontas

et al. 2009

The Journal of Clinical Pharma

161

107

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Ketamine, the phencyclidine derivative described in 1965, is an intravenous anesthetic with a variety of applications. The enthusiasm following its initial release subsided due to side effects from the central nervous system. New anesthetics limited the role of ketamine in anesthetic practice. However, its hemodynamically stable profile, along with its beneficial respiratory properties and analgesic potency, rendered the drug invaluable in battlefield medicine, sedation of the uncooperative child, analgesia, and sedation in burn units. Reevaluation, though, of analgesic properties of ketamine resulted in new interest regarding its use in perioperative and chronic pain management. Moreover, recent studies in the effects of the substance on intracranial pressure and cerebral blood flow led to revising the recommendation against its use in brain injury. Furthermore, the bronchodilating effects of the substance led to increasing interest for potential use in asthma treatment. In addition, separation of the 2 enantiomers and subsequent separate studies indicated beneficial results of the S(+) one. Thus, new controlled multicentered clinical trials are to be conducted to justify approval for new uses of ketamine and take advantage of its unique range of applications.

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Endocrine responses to total intravenous anesthesia with droperidol, fentanyl, and ketamine in cardiac patients

et al. 1995

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Ketamine-induced sympathetic stimulation can be inhibited by administration of sedatives such as benzodiazepines, droperidol, or opioids. We have developed total intravenous anesthesia with ketamine in combination with droperidol and fentanyl (DFK) and have used this anesthetic method in more than 4000 surgical cases. In this study, we compared DFK in cardiac surgery with isoflurane-fentanyl anesthesia (AOI-F). Fourteen patients undergoing aortocoronary artery bypass graft surgery were randomly assigned to the DFK or AOI-F groups. The endocrine responses of the patients were evaluated from the plasma, levels of cortisol, antidiuretic hormone (ADH), atrial natriuretic peptide (ANP), and aldosterone. In both groups, anesthesia per se did not induced any significant changes in the hormones. Although cortisol and ADH increased during surgery, ANP and aldosterone did not change appreciably. All hormones were significantly elevated after the end of cardiopulmonary bypass. There were no significant differences in any of the hormones, blood pressure, and heart rate measured at different points in both groups. These results showed that DFK anesthesia as a total intravenous anesthesia deserves to be studied in more depth.

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Effects of high-dose fentanyl on fluid and vasopressor requirements after cardiac surgery

Cited by 18 publications

References 14 publications

Oral clonidine premedication attenuates the haemodynamic effects associated with ketamine anaesthetic induction in humans

Oral clonidine premedication attenuates the haemodynamic effects associated with ketamine anaesthetic induction in humans

Pharmacological Aspects and Potential New Clinical Applications of Ketamine: Reevaluation of an Old Drug

Endocrine responses to total intravenous anesthesia with droperidol, fentanyl, and ketamine in cardiac patients

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