The mechanisms of the direct vascular effects of fentanyl on isolated human saphenous veins in vitro

Şahin, Ayşe; Duman, Ateş; Atalik, E. K.; Öğün, Cemile Öztin; Şahin, Tahir Kemal; Erol, Atilla; Özergin, Ufuk

doi:10.1053/j.jvca.2005.01.031

Cited by 17 publications

(10 citation statements)

References 17 publications

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“…The number of studies using isolated human vessels 122, 144,146,151,168,183,193,202,223,[302][303][304][305][306][307][308] is increasing, and they have reported both similarities and differences in vascular responsiveness to general anesthetics between humans and animals. However, as discussed above, the underlying mechanisms are not entirely clear.…”

Section: Investigations With Human Vesselsmentioning

confidence: 99%

“…However, as discussed above, the direct action of volatile anesthetics on arterial VSMCs may contribute to the prolonged systemic hypotension observed during the postanesthesia period. 157,158,294,303,305,307,308,[317][318][319] Again, on consideration of possible species differences, further studies using human capacitance vessels, as well as human systemic resistance vessels, would be essential to evaluate a possibility that the direct (i.e., nonneural) actions of general anesthetics on VSMCs contribute to systemic hypotension during their administration. 2 In previous studies with isolated mesenteric veins, 157,158,317 halothane, enflurane, and isoflurane inhibited the contractile response to norepi- nephrine.…”

Section: Investigations With Systemic Resistance and Capacitance Vesselsmentioning

confidence: 99%

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General Anesthetics and Vascular Smooth Muscle

Akata

2007

Anesthesiology

101

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General anesthetics threaten cardiovascular stability by causing changes in cardiac function, vascular reactivity, and cardiovascular reflexes and significantly alter distribution of cardiac output to various organs. Their overall impact is often systemic hypotension, which is attributable to myocardial depression, peripheral vasodilation, and attenuated sympathetic nervous system activity. However, one could be more causative than the others, depending on anesthetic agents and cardiovascular factors inherent in patients (e.g., coexisting heart disease). It is generally believed that most general anesthetics attenuate sympathetic nervous system outflow from the central nervous system, thereby decreasing vascular resistance in peripheral circulations. Indeed, in previous in vivo studies, during administration of various general anesthetics, vascular resistance was decreased in most peripheral circulations; however, it was unaffected or increased in some peripheral circulations. General anesthetics may act directly on vascular smooth muscle and/or endothelial cells in various vascular beds, influencing total peripheral and/or regional vascular resistance, and hence organ blood flow. This article reviews previously reported direct (i.e., nonneural) vascular actions of general anesthetics and discusses their underlying mechanisms, their in vivo relevance, and the future of research for general anesthetic vascular pharmacology.

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Section: Investigations With Human Vesselsmentioning

confidence: 99%

Section: Investigations With Systemic Resistance and Capacitance Vesselsmentioning

confidence: 99%

General Anesthetics and Vascular Smooth Muscle

Akata

2007

Anesthesiology

101

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“…13 Clonidine in high concentration also produces vasodilatation through sustained stimulation of alpha 2-receptors on endothelial cells. 14 Fentanyl has similar vasodilator effects on the vascular smooth muscle, 15 but probably of a smaller extent as the Cpmax levobupivacaine after paravertebral bolus in LC patients was significantly higher than LF patients (P Ͻ .02). Therefore, although no toxic levels were achieved at the low doses we used in this study, we have to be aware of the combined vasodilator effect when clonidine is added to clinical concentrations of levobupivacaine in paravertebral block.…”

Section: Discussionmentioning

confidence: 94%

Pharmacokinetics of Levobupivacaine, Fentanyl, and Clonidine After Administration in Thoracic Paravertebral Analgesia

Burlacu

Frizelle

Moriarty

et al. 2007

Regional Anesthesia and Pain Medicine

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“…Administration of etomidate in combination with fentanyl has been suggested for induction of anaesthesia in high-risk patients for cardiac surgery, because of their minor cardiovascular effects [1]. The partly opposed effects of etomidate and fentanyl on heart rate and blood pressure do not allow to predict the adequacy of anaesthesia on the basis of these parameters [2-4]. This is particularly the case in cardiac high-risk patients, whose heart rate and blood pressure behaviour are often dictated by the underlying heart impairment and by heart medication.…”

Section: Introductionmentioning

confidence: 99%

Prospective study comparing skin impedance with EEG parameters during the induction of anaesthesia with fentanyl and etomidate

Winterhalter

Münte²,

Gerhard

et al. 2010

Eur J Med Res

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Objective Sympathetic stimulation leads to a change in electrical skin impedance. So far it is unclear whether this effect can be used to measure the effects of anaesthetics during general anaesthesia. The aim of this prospective study is to determine the electrical skin impedance during induction of anaesthesia for coronary artery bypass surgery with fentanyl and etomidate. Methods The electrical skin impedance was measured with the help of an electro-sympathicograph (ESG). In 47 patients scheduled for elective cardiac surgery, anaesthesia was induced with intravenous fentanyl 10 μg/kg and etomidate 0.3 mg/kg. During induction, the ESG (Electrosympathicograph), BIS (Bispectral IndeX), BP (arterial blood pressure) and HR (heart rate) values of each patient were recorded every 20 seconds. The observation period from administration of fentanyl to intubation for surgery lasted 4 min. Results The ESG recorded significant changes in the electrical skin impedance after administration of fentanyl and etomidate(p < 0.05). During induction of anaesthesia, significant changes of BIS, HR and blood pressure were observed as well (p < 0.05). Conclusions The electrical skin impedance measurement may be used to monitor the effects of anesthetics during general anaesthesia.

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The mechanisms of the direct vascular effects of fentanyl on isolated human saphenous veins in vitro

Cited by 17 publications

References 17 publications

General Anesthetics and Vascular Smooth Muscle

General Anesthetics and Vascular Smooth Muscle

Pharmacokinetics of Levobupivacaine, Fentanyl, and Clonidine After Administration in Thoracic Paravertebral Analgesia

Prospective study comparing skin impedance with EEG parameters during the induction of anaesthesia with fentanyl and etomidate

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