Satoru Tanaka1, Hideaki Tsuchida1, Hajime Sonoda2, Akiyoshi Namiki1. 1. Department of Anesthesiology, Sapporo Medical University School of Medicine, South 1, West 16, Chuo-ku, 060-0061, Sapporo, Japan. 2. Department of Anesthesia, Kushiro Municipal General Hospital, 1-12 Shunkodai, 085-0822, Kushiro, Japan.
Abstract
PURPOSE: To determine whether fentanyl augments respiratory and cardiovascular problems during propofol-induced sedation, we investigated the effects of propofol and fentanyl on respiratory and hemodynamic profiles in 30 female patients under spinal anesthesia, administering oxygen via face mask. METHODS: After spinal anesthesia, 20 patients were sedated withpropofol (0.5 mg·kg-1 bolus, 3 mg·kg-1·h-1), followed by administration of either 2 μg·kg-1 fentanyl in group PF or normal saline in group P, whereas another 10 patients (group F) received 2 μg·kg-1 fentanyl without propofol. We measured heart rate, mean arterial pressure, end-tidal carbon dioxide tension, and respiratory rate before and after treatment. We also evaluated apnea, arterial oxygen desaturation, and airway obstruction. RESULTS:Mean arterial pressure was significantly lower in group P and PF than in group F. However, there were comparable changes in heart rate in the three groups. The combination of fentanyl and propofol decreased respiratory rate and increased end-tidal carbon dioxide tension more than fentanyl or propofol alone. Although apnea occurred in groups F and PF, arterial oxygen desaturation did not occur in any of the groups. CONCLUSION: The combination of fentanyl and propofol augmented the risks of respiratory depression and apnea compared with the use of fentanyl or propofol alone.
RCT Entities:
PURPOSE: To determine whether fentanyl augments respiratory and cardiovascular problems during propofol-induced sedation, we investigated the effects of propofol and fentanyl on respiratory and hemodynamic profiles in 30 female patients under spinal anesthesia, administering oxygen via face mask. METHODS: After spinal anesthesia, 20 patients were sedated with propofol (0.5 mg·kg-1 bolus, 3 mg·kg-1·h-1), followed by administration of either 2 μg·kg-1 fentanyl in group PF or normal saline in group P, whereas another 10 patients (group F) received 2 μg·kg-1 fentanyl without propofol. We measured heart rate, mean arterial pressure, end-tidal carbon dioxide tension, and respiratory rate before and after treatment. We also evaluated apnea, arterial oxygen desaturation, and airway obstruction. RESULTS: Mean arterial pressure was significantly lower in group P and PF than in group F. However, there were comparable changes in heart rate in the three groups. The combination of fentanyl and propofol decreased respiratory rate and increased end-tidal carbon dioxide tension more than fentanyl or propofol alone. Although apnea occurred in groups F and PF, arterial oxygen desaturation did not occur in any of the groups. CONCLUSION: The combination of fentanyl and propofol augmented the risks of respiratory depression and apnea compared with the use of fentanyl or propofol alone.
Authors: D J Pavlin; B Coda; D D Shen; J Tschanz; Q Nguyen; R Schaffer; G Donaldson; R C Jacobson; C R Chapman Journal: Anesthesiology Date: 1996-01 Impact factor: 7.892