The Effect of Fentanyl on Arginine Vasopressin and Cortisol Secretion during Anesthesia

Lehtinen, A; Fyhrquist, Frej; I, Kivalo

doi:10.1213/00000539-198401000-00005

Cited by 16 publications

(7 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Vasopressin is released into the circulation as a result of decreased baroreceptor activity during hypotensive or shock states and as a result of increases in plasma osmolality. 15 Pure µ-opioid receptor agonists may cause the release of vasopressin, 11,13 albeit the mechanism of vasopressin release under these circumstances is poorly understood. The increase in vasopressin concentrations could have been attributed to a direct action of remifentanil at µ-opiod receptors located in the CNS, 11 or it could have been a physiologic response 16 to the decrease in arterial blood pressure (associated with the decrease in CO) induced by remifentanil.…”

Section: Discussionmentioning

confidence: 99%

“…12 When administration of fentanyl (0.002 mg/kg, as an IV bolus) was compared with administration of halothane for maintaining anesthesia in humans receiving nitrous oxide and oxygen, the opioid caused an increase in plasma vasopressin concentrations that was blunted by prior administration of naloxone. 13 Vasopressin has vasoconstrictive properties mediated by activation of V 1 receptors within the vascular smooth muscles and may result in increased SVR, decreased CO, and decreased oxygen delivery. 14,15 The relationship between vasopressin release and opioid-induced changes in hemodynamic function has not been established.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Hemodynamic effects in dogs anesthetized with isoflurane and remifentanil-isoflurane

Monteiro¹,

Neto²,

Campagnol³

et al. 2010

ajvr

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Hemodynamic effects in dogs anesthetized with isoflurane and remifentanil-isoflurane

Monteiro¹,

Neto²,

Campagnol³

et al. 2010

ajvr

View full text Add to dashboard Cite

show abstract

“…µ-agonist opioids can release vasopressin into the circulation, but the mechanism of this effect it not yet clear (HELLEBREKERS et al, 1989). Vasopressin acts on V1 receptors located in the smooth muscle cells of blood vessels to induce vasoconstriction, which increases systemic vascular resistance (LEHTINEN et al, 1984).…”

Section: Discussionmentioning

confidence: 99%

Avaliação da concentração expirada de isoflurano em infusão continua de remifentanil em cadelas submetidas a mastectomia

et al. 2015

View full text Add to dashboard Cite

The aims of this study were to evaluate the effects of two constant rate infusions of remifentanil on end tidal isoflurane (ETiso) in dogs undergoing mastectomy surgery. Eighteen bitches, 12+2 years of age, weighing 15+5 Kg were randomized into 3 groups (n=6/group) and underwent unilateral mastectomy due to mammary neoplasia. All animals received the premedications of morphine (0.5 mg Kg -1 ) and acepromazine (0.03 mg Kg -1 ) by intramuscular route (IM). Propofol dose-effect was used for induction of anesthesia. The animals were intubated and connected to a circle breathing system, and IPPV (intermittent positive pressure ventilation) was used to maintain normocapnia with an oxygen flow rate of 2 L/min and FiO 2 100%. Anesthesia was maintained with isoflurane and saline solution (control group [GCON], n=6) or intravenous infusion of remifentanil at a rate of 0.15 µg Kg -1 min -1 (REMI 0.15 n=6) or 0.3 µg Kg -1 min -1 (REMI 0.3 n=6). Cardiopulmonary variables and ETiso were monitored before and every 15 minutes after the start of surgery. The data were analyzed by ANOVA with multiple repetitions between moments and ANOVA followed by the Student Newman Keuls test (≤0.05) for comparisons between groups. Heart rate was lower at all moments in the REMI 0.15 and REMI 0.3 groups than in the GCON, and heart rate was not significantly different between the two remifentanil infusion groups. Additionally, the arterial blood pressure values (SAP, MAP and DAP) were not different between all groups. Baseline values (before surgery) of ETiso were not different between the 3 groups. After the start of surgery, ETiso ranged from 1.37±0.3 to 1.05±0.19 in the control group; in the REMI 0.15 and REMI 0.3 groups, ETiso was 36.5% and 65.7% lower than in the control group (M15). Remifentanil infusion reduced ETiso in a dose-dependent manner in animals undergoing radical mastectomy without causing significant cardiopulmonary alterations. Key words: Dogs, mastectomy, remifentanil, isoflurane ResumoOs objetivos deste estudo são a avaliação dos efeitos de duas taxas fixas de infusão continua de remifentanil na concentração expirada de isoflurano (ETiso) em cadelas submetidas à mastectomia. aleatoriamente em 3 grupos (n=6/grupo) e submetidos à mastectomia unilateral devido a neoplasia mamária. Todos os animais foram pré-medicados com morfina (0,5 mg Kg -1 ) e acepromazina (0,03 mg Kg -1 ), ambas por via intramuscular (IM). A indução da anestesia foi realizada com propofol (doseefeito). Os animais foram intubados e conectados a um sistema circular com reinalação de gases. Foi utilizada ventilação com pressão positiva intermitente para manutenção de normocapnia com fluxo de oxigênio de 2 L/min e FiO 2 de 100%. A anestesia foi mantida com isoflurano e solução salina (grupo controle [GCON], n=6) ou infusão intravenosa de remifentanil na taxa de 0,15 µg Kg -1 min -1 (REMI 0,15 n=6) ou 0,3 µg Kg -1 min -1 (REMI 0,3 n=6). As variáveis cardiovasculares e a ETiso foram monitoradas antes e a cada 15 minutos após o início da cirurgia. Os dado...

show abstract

“…Acute increases in serum sodium levels can cause cerebral dehydration, potentially resulting into rupture of dural bridging veins, cerebral hemorrhages, venous sinus thrombosis, cerebral demyelination, and rhabdomyolysis [ 7 ]. There have been case reports wherein the use of certain anesthetic drugs was suspected to cause intraoperative polyuria, mainly including dexmedetomidine [ 8 – 15 ], ketamine [ 16 – 19 ], propofol [ 20 – 23 ], sevoflurane [ 24 , 25 ], remifentanil [ 26 ], and fentanyl [ 27 ]. A review paper published in the journal Anesthesia and Analgesia in 2021 reviewed 24 case reports of intraoperative polyuria due to anesthetic drugs and their possible mechanisms [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Establishment and validation of a predictive nomogram for polyuria during general anesthesia in thoracic surgery

Li,

Zhang

2024

J Cardiothorac Surg

View full text Add to dashboard Cite

Background To develop and evaluate a predictive nomogram for polyuria during general anesthesia in thoracic surgery. Methods A retrospective study was designed and performed. The whole dataset was used to develop the predictive nomogram and used a stepwise algorithm to screen variables. The stepwise algorithm was based on Akaike’s information criterion (AIC). Multivariable logistic regression analysis was used to develop the nomogram. The receiver operating characteristic (ROC) curve was used to evaluate the model’s discrimination ability. The Hosmer–Lemeshow (HL) test was performed to check if the model was well calibrated. Decision curve analysis (DCA) was performed to measure the nomogram’s clinical usefulness and net benefits. P < 0.05 was considered to indicate statistical significance. Results The sample included 529 subjects who had undergone thoracic surgery. Fentanyl use, gender, the difference between mean arterial pressure at admission and before the operation, operation type, total amount of fluids and blood products transfused, blood loss, vasopressor, and cisatracurium use were identified as predictors and incorporated into the nomogram. The nomogram showed good discrimination ability on the receiver operating characteristic curve (0.6937) and is well calibrated using the Hosmer–Lemeshow test. Decision curve analysis demonstrated that the nomogram was clinically useful. Conclusions Individualized and precise prediction of intraoperative polyuria allows for better anesthesia management and early prevention optimization.

show abstract

The Effect of Fentanyl on Arginine Vasopressin and Cortisol Secretion during Anesthesia

Cited by 16 publications

References 0 publications

Hemodynamic effects in dogs anesthetized with isoflurane and remifentanil-isoflurane

Hemodynamic effects in dogs anesthetized with isoflurane and remifentanil-isoflurane

Avaliação da concentração expirada de isoflurano em infusão continua de remifentanil em cadelas submetidas a mastectomia

Establishment and validation of a predictive nomogram for polyuria during general anesthesia in thoracic surgery

Contact Info

Product

Resources

About