Questioning the cardiocirculatory excitatory effects of opioids under volatile anaesthesia

Abstract

We have demonstrated that low-dose sufentanil-induced haemodynamic hyper-reactivity is an excitatory micro -opiate-related phenomenon. This effect is reversed by drugs effective in treating opiate-induced hyperalgesia.

The effect of ketamine on the MACBAR of sevoflurane in dogs

“…It is of interest that some animal studies show only a minimal difference between MAC and MAC BAR . In sevoflurane‐anesthetized rats subjected to a variety of noxious stimuli, MAC BAR did not differ significantly from MAC (Docquier et al. 2004).…”

“…Ketamine reduces the MAC of sevoflurane (Wilson et al 2008b) and isoflurane Solano et al 2006;Pypendop et al 2007) in dogs in a dose-dependent but nonlinear manner. In addition, ketamine decreases the MAC BAR of sevoflurane in rats (Docquier et al 2004).…”

“…Importantly, the use of adjunctive drugs, such as opioids, can diminish the hemodynamic consequences of high doses of inhalational anesthetics by decreasing the MAC BAR to clinically relevant concentrations (Katoh et al. 2000; Docquier et al. 2004; Albertin et al.…”

“…2007) in dogs in a dose‐dependent but non‐linear manner. In addition, ketamine decreases the MAC BAR of sevoflurane in rats (Docquier et al. 2004).…”

“…Because the cardiovascular depression produced by inhalational anesthetics is dose-dependent (Gentry-Smetana et al 2008), the concentrations required to block the autonomic response can generate considerable cardiovascular instability (Pypendop & Ilkiw 2004). Importantly, the use of adjunctive drugs, such as opioids, can diminish the hemodynamic consequences of high doses of inhalational anesthetics by decreasing the MAC BAR to clinically relevant concentrations (Katoh et al 2000;Docquier et al 2004;Albertin et al 2006).…”