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British Journal of Anaesthesia, 1986, Vol. 58, No. 4 406-414
© 1986 The Board of Management and Trustees of the British Journal of Anaesthesia

other

EFFECTS OF FENTANYL-DIAZEPAM-NITRIOUS OXIDE ANAESTHESIA ON ARTERIAL BAROREFLEX CONTROL OF HEART RATE IN MAN

K. J. KOTRLY, M.D.*, T. J. EBERT, M.D., PH.D., E. J. VUCINS, M.D., D. L. ROERIG, PH.D., A. STADNICKA, PH.D. and J. P. KAMPINE, M.D., PH.D.

The Medical College of Wisconsin, and VA Medical Center Milwaukee, Wisconsin
The Medical College of Wisconsin, and VA Medical Center Milwaukee, Wisconsin
Department of Anesthesiology, The Medical College of Wisconsin, and VA Medical Center Milwaukee, Wisconsin
Departments of Pharmacology-Toxicology and Anesthesiology, The Medical College of Wisconsin, and VA Medical Center Milwaukee, Wisconsin
Department of Physiology, The Medical College of Wisconsin, and VA Medical Center Milwaukee, Wisconsin
Department of Anesthesiology, The Medical College of Wisconsin, and VA Medical Center Milwaukee, Wisconsin

* VA Medical Center, Anesthesiology Service/112A, 5000W. National Avenue, Milwaukee, Wisconsin 53193, U.S.A.

The effects of fentanyl 7.5 µg kg–l (group I), 10.0 µg kg–1 (group Il) and 12.5 µg kg–1 (group lll) with diazepam 0.25 mg kg–l and 70% nitrous oxide on baroreflex control of heart rate in humans were investigated. Phenylephrine (the pressor test), sodium nitroprusside (the depressor test) and graded neck suction provoked baroreflex responses. In group I the pressor, depressor and neck suction baroreflex slopes decreased during anaesthesia. In groups II and III the depressor test slopes were also decreased during anaesthesia. However, the slopes derived from the pressor and neck suction tests did not decrease. These data suggest that baroreflex control of heart rate is attenuated during low doses of fentanyl (7.5 µg kg–1). Baroreflex mediated tachycardia is decreased by higher doses of fentanyl (10.0 and 12.5 µg kg–1). However, baroreflex-mediated bradycardia is maintained during the higher doses of fentanyl. We suggest this effect is the result of enhanced vagal efferent activity mediated by fentanyl.


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