The influence of fentanyl on the cardiovascular effect of suxamethonium

Abstract

The influence of fentanyl on the cardiovascular effect of a single dose of suxamethonium was evaluated during thiopentone N2O/O2 anaesthesia. Sixty adult patients were randomly allocated to three groups. In one group (control group) no fentanyl was given. In two groups fentanyl 0.002 mg/kg and 0.004 mg/kg, respectively, was given before induction of anaesthesia. Three minutes after the injection of suxamethonium 1 mg/kg, both heart rate (HR) and mean arterial pressure (MAP) in the two groups receiving fentanyl were significantly lower than in the control group. However, the absolute changes were small and no dose-related effect was seen. An estimation of the change in HR following suxamethonium was made using as predictors initial HR before induction of anaesthesia, age, sex, and the injection of fentanyl. The higher the initial HR, the greater was the chance of a decrease in HR following suxamethonium. Injection of fentanyl lowered the threshold HR above which a decrease was to be expected following injection of suxamethonium. This effect was most pronounced among the younger patients. It is concluded that injection of fentanyl potentiates the decrease in HR sometimes seen after a single dose of suxamethonium and that this effect is influenced by HR before induction of anaesthesia and by age of the patient.