Effects of Fentanyl on Baroreceptor Reflex Control of Heart Rate in Newborn Infants

Murat, I.; Levron, Jean-Claude; Berg, Alain; Saint-Maurice, C

doi:10.1097/00000542-198805000-00009

Cited by 58 publications

(20 citation statements)

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“…anaesthetic agents and/or epidural analgesia should be concomitantly administered for surgical anaesthesia. Since these drugs/techniques may alter baroreflex responses or cardiac autonomic activity, [17][18][19] their combined effects with propofol on cardiovagal function should be evaluated. Lastly, since median performance error for blood propofol concentration calculated by the TCI system was reported to be 16.1% higher than the directly measured concentration, 20 the median blood propofol concentration in our subjects could have been $5.8 mg ml À1 .…”

Section: Discussionmentioning

confidence: 99%

Baroreflex control of heart rate during and after propofol infusion in humans

Satô

Tanaka

Umehara

et al. 2005

British Journal of Anaesthesia

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Section: Discussionmentioning

confidence: 99%

Baroreflex control of heart rate during and after propofol infusion in humans

Satô

Tanaka

Umehara

et al. 2005

British Journal of Anaesthesia

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“…There is little published information about the effects of opioid anaesthetic agents on reflex control of the heart and circulation in humans. In newborn infants, fentanyl depresses the baroreceptor-heart rate reflex (Murat et al 1988). In adults, the vasoconstrictor response to LBNP was unaffected by fentanyl-diazepam anaesthesia, though cardiac output was allowed to fall by only 24% (Ebert el al.…”

Section: Effects On the Response To Acute Central Hypovolaemia And Onmentioning

confidence: 99%

Effects of Halothane, Ketamine, Propofol and Alfentanil Anaesthesia on Circulatory Control in Rabbits

Leeuwen

Evans

Ludbrook

1990

Clin Exp Pharma Physio

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1. We have made a within-rabbit comparison of the effects of four general anaesthetic regimens on the haemodynamic response to acute reduction in central blood volume and on baroreflex control of heart rate. 2. Acute haemorrhage was simulated by gradually inflating a cuff on the inferior vena cava in order to cause cardiac output to fall at a constant rate of 8.5%/min while the responses of systemic vascular resistance, arterial pressure and heart rate were measured. The full range of the baroreceptor-heart rate reflex was elicited by inflating aortic and vena caval cuffs. These indices of circulatory control were repeatedly measured within five protocols, to which each rabbit was exposed in randomized order. 3. In each protocol the rabbit was first studied unanaesthetized. Then a small dose of thiopentone sodium was given (16 mg/kg). In the four main protocols the rabbit was then intubated and ventilated, first with 100% oxygen and then with 50% nitrous oxide, during administration of one of four anaesthetic agents. These were halothane (2.0 and 2.5%), ketamine (2.5 mg/kg per min), propofol (0.83 and 1.25 mg/kg per min) and alfentanil (2.5 and 3.33 micrograms/kg per min). In a sham protocol the effects of 100% oxygen, then those of 50 and 75% nitrous oxide, were studied while the rabbit remained conscious. 4. In unanaesthetized rabbits, in the presence or absence of nitrous oxide, the normal biphasic haemodynamic response to simulated haemorrhage occurred. The first, vasoconstrictor, phase was attenuated by halothane, ketamine and propofol, so that arterial pressure fell more steeply than normal. Not only was the vasoconstrictor phase unaffected by alfentanil but it was extended, so that arterial pressure remained at a normal level even when cardiac output had fallen by 59%. This effect of alfentanil appeared to be mediated centrally, since it could be reproduced by injecting small doses (1.5-7.5 micrograms) into the fourth ventricle. All four anaesthetic agents and nitrous oxide attenuated the baroreceptor control of heart rate. The effect was least with nitrous oxide and alfentanil, greatest with halothane.

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“…[2][3][4] The baroreflex becomes functional late in gestation, and its sensitivity then increases gradually, but in the neonate, it is still much below the level that has been reported for young adults. 5,6 There are no data in the literature about cardiovagal autonomic function between infancy and young adulthood. This lack of information is surprising, because this is an important period of life, when children increase their physical activities, face intellectual challenges at school, and undergo profound hormonal changes associated with puberty.…”

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confidence: 99%

Maturation of Cardiovagal Autonomic Function From Childhood to Young Adult Age

et al. 2004

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Background-Cardiovagal autonomic control declines with age in adult subjects, which is related in part to increasing stiffness of the barosensory vessel wall. It is not known, however, whether autonomic function changes with age in children. Methods and Results-We studied 137 healthy subjects divided into 4 age groups: group 1, 7 to 14 years; group 2, 11 to 14 years; group 3, 15 to 18 years; and group 4, 19 to 22 years. Brachial artery pressure was measured by sphygmomanometry and continuous radial artery pressure and carotid artery pulse pressure (⌬P) by applanation tonometry. The R-R interval was derived from the ECG. Autonomic function was assessed by spontaneous sequence and frequency-domain indices, which indicate the extent of coupling between fluctuations in heart rate and systolic pressure. Carotid artery diastolic diameter (DD) and pulsatile distension (⌬D) were measured by echo wall tracking; carotid compliance coefficient (CC) was defined as ⌬D/⌬P and distensibility coefficient as 2⌬D/DD · ⌬P. , with no significant changes afterward. CC and DC were inversely proportional to age (rϭϪ0.49 and Ϫ0.62, respectively, PϽ0.001). The efficiency of neural integrative mechanisms, estimated as the ratio of spontaneous indices and CC, more than doubled from group 1 to group 3. Spontaneous indices were linearly related to measures of cardiac vagal activity. Conclusions-The increase in spontaneous indices from early childhood to adolescence, despite gradual stiffening of the carotid artery, may indicate improved cardiovagal autonomic function, which is most likely a result of maturation of neural mechanisms, attaining peak level at adolescence.

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Effects of Fentanyl on Baroreceptor Reflex Control of Heart Rate in Newborn Infants

Cited by 58 publications

References 0 publications

Baroreflex control of heart rate during and after propofol infusion in humans

Baroreflex control of heart rate during and after propofol infusion in humans

Effects of Halothane, Ketamine, Propofol and Alfentanil Anaesthesia on Circulatory Control in Rabbits

Maturation of Cardiovagal Autonomic Function From Childhood to Young Adult Age

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