Morphine Decreases Peripheral Vascular Resistance and Increases Capacitance in Man

Hsu, Hsian-He; Hickey, Robert F.; Forbes, A. R.

doi:10.1097/00000542-197902000-00005

Cited by 57 publications

(22 citation statements)

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“…In our experience, shivering can be managed without the use of paralytic agents in most patients in the setting of intensive care. This phenomenon occurs not only with volatile anesthetics but also with intravenous anesthetics and analgesics (32)(33)(34)(35)(36)(37)(38). First, although muscular shivering activity will be blunted by paralysis, there will be no effect at the central level; in other words, the brain's attempts to generate a shivering response will not cease.…”

Section: Induction Of Hypothermiamentioning

confidence: 99%

Therapeutic hypothermia and controlled normothermia in the intensive care unit: Practical considerations, side effects, and cooling methods*

Polderman

Herold

2009

Critical Care Medicine

628

543

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Temperature management and hypothermia induction are gaining importance in critical care medicine. Intensive care unit physicians, critical care nurses, and others (emergency physicians, neurologists, and cardiologists) should be familiar with the physiologic effects, current indications, techniques, complications and practical issues of temperature management, and induced hypothermia. In experienced hands the technique is safe and highly effective.

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Section: Induction Of Hypothermiamentioning

confidence: 99%

Therapeutic hypothermia and controlled normothermia in the intensive care unit: Practical considerations, side effects, and cooling methods*

Polderman

Herold

2009

Critical Care Medicine

628

543

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“…To delineate the effects and the dose-effect relationship of vasoactive drugs on peripheral vasculature, cardiopulmonary bypass can be used as an experimental model since during aortic cross-clamping, the cardiac responses are excluded. In addition, the effects of the drug on SVR and venous capacitance may be studied separately during CPB (5)(6)(7). Since the level of SVR can be altered by the type of flow (8,9), the effect of droperidol in different SVR states can be assessed.…”

mentioning

confidence: 99%

Effects of droperidol on peripheral vasculature: use of cardiopulmonary bypass as a study model

Videcoq

Marty

et al. 1987

Acta Anaesthesiol Scand

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The effects of droperidol on the systemic vascular resistance (SVR) and the venous capacitance were studied during cardiopulmonary bypass (CPB) in 24 patients. CPB was performed with either pulsatile or non-pulsatile flow. During non-pulsatile flow, droperidol (0.15 mg X kg-1 and 0.30 mg X kg-1) decreased SVR and increased venous capacitance. These values were significantly different after the 2nd and the 7th min, respectively. During pulsatile flow, the initial SVR was lower. The decremental effect of 0.30 mg X kg-1 droperidol on SVR was proportional to the preinjection level of SVR (r = 0.64). The increase in venous capacitance related to droperidol was independent of the dose and of the type of flow in all patients. It can be concluded that the vasodilating action of droperidol during CPB on the arterial bed is transient, independent of dose, and related to the preinjection level of SVR. The effect of droperidol on venous capacitance is not as rapid but has a longer duration.

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“…Thus extreme doses would be expected to elicit some histamine release in all subjects (e.g., when Hsu et al (34) gave morphine in the form of an intraarterial bolus), and lower doses or rates of administration would release little or no histamine. Clear-cut dose-response curves for histamine release have been reported only for in vitro preparations (1,39-41).…”

Section: Discussionmentioning

confidence: 99%

Histamine Release by Four Narcotics

Flacke

Bloor

et al. 1987

Anesthesia & Analgesia

151

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FLACKE, JW, FL.ACKE WE, BLOOR BC, VAN E'lTEN AP, KRIPKE BJ. Histamine release by four narcotics: a double-blind study in humans. Anesth Analg 1987;66:723-30. Histamine release and hemodynamic changes associated w'th four narcotics were studied in 60 adults (28 men, 32 women) scheduled for general surgery under balanced anesthesia. Under doublt-blind conditions, insremental equiptent doses of meperidine, morphine, fentanyl, or sufentanil were administered IV for induction of anesthesia, prior to thiopental, succinylcholine, and intubation. Arterial blood samples were drawn before and I, 6 , and 20 min after narcotic administration. Of the 16 patients given meperidine (mean dose 4.3 2 0.2 (SEM) mglkg), five (31 %) had clinical signs (hypotension, tachycardia, erythema) and e l m t i a s in plasma histamine levels rangingfrom 3.2 to 49.7 nglml 1 min after narcotic administration. Plasma epinephrine levels at this time were also elevated in these five patients. One of the ten patients given morphine (0.6 2 0.02 mglkg) developed hypotension, tachycardia, and an increase in plasma histamine level to 12.4 nglml. None of34 patientsgiven either fentanyl (7 2 0.4 pglkg) or sufentanil (1.3 f 0.1 kglkg) had clinical signs of histamine release or elevations of plasma histamine levels. In the six patients in whom histamine release occurred, there was a significant correlation between the histamine levels at 1 min and the magnitude of change in heart rate, blood pressure, and plasma epinephrine level. All six histamine releasers were young women, ranging in age from 18 to 35 yr. Histamine release occurred more frequently after meperidine than after the other narcotics, including morphine, and the degree of hemodynamic compromise was related to the increase in plasma histamine concentration.

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Morphine Decreases Peripheral Vascular Resistance and Increases Capacitance in Man

Cited by 57 publications

References 0 publications

Therapeutic hypothermia and controlled normothermia in the intensive care unit: Practical considerations, side effects, and cooling methods*

Therapeutic hypothermia and controlled normothermia in the intensive care unit: Practical considerations, side effects, and cooling methods*

Effects of droperidol on peripheral vasculature: use of cardiopulmonary bypass as a study model

Histamine Release by Four Narcotics

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