PMID: 9447854Feb 3, 1998Paper

Fentanyl augments the blockade of the sympathetic response to incision (MAC-BAR) produced by desflurane and isoflurane: desflurane and isoflurane MAC-BAR without and with fentanyl

Anesthesiology
M DanielE I Eger

Abstract

Heart rate (HR) or mean arterial blood pressure (MAP) may increase in response to incision despite the absence of a motor response. The authors hypothesized that the MAC-BAR (minimum alveolar concentration of an anesthetic that blocks adrenergic response to incision) for isoflurane would exceed that for desflurane, and that fentanyl would decrease the MAC-BAR for each anesthetic in a dose-dependent manner. Seventy-one patients were randomly allocated to one of six groups: desflurane or isoflurane without fentanyl or with 1.5 or 3 microg/kg fentanyl given intravenously 5 min before surgical incision. Anesthesia was induced with 2 mg/kg propofol given intravenously, and tracheal intubation facilitated with 0.1 mg/kg given intravenously. The first patient in each group received 1 MAC (end-tidal) of the inhaled anesthetic in 60% nitrous oxide (0.55 MAC), balance oxygen, maintained for at least 10 min before incision. The response was considered positive if the HR or MAP increased 15% or more. If the response was positive, the end-tidal concentration given to the next patient was 0.3 MAC greater; if the response was negative, the end-tidal concentration was 0.3 MAC less. The MAC-BAR level was calculated as the mean of four independe...Continue Reading

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Citations

Nov 8, 2001·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·M NakayamaA Namiki
Feb 28, 2001·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·T J EbertJ A Barney
May 29, 2007·Der Anaesthesist·S KreuerT Bouillon
Apr 12, 2008·World Journal of Pediatrics : WJP·Xuan Wang, Xue-Feng Zhang
Jun 1, 2005·Annales Françaises D'anesthèsie Et De Rèanimation·S Passot, S Molliex
Jul 15, 2005·Best Practice & Research. Clinical Anaesthesiology·Benedikt Preckel, Jens Bolten
Aug 17, 2001·International Anesthesiology Clinics·Y NakataS Morita
Sep 23, 2009·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Justin H BoothHenry M Spotnitz
Jan 5, 2002·Anesthesia and Analgesia·Marco GemmaArmando Soldarini
Apr 3, 2008·American Journal of Veterinary Research·Erik H HofmeisterAshley M Cruse
Apr 16, 2011·Veterinary Anaesthesia and Analgesia·Reza SeddighiThomas J Doherty
Jun 2, 2011·Veterinary Anaesthesia and Analgesia·Lydia LoveThomas Doherty
May 4, 2004·Annales Françaises D'anesthèsie Et De Rèanimation·X Viviand, F Garnier
Apr 26, 2006·Best Practice & Research. Clinical Anaesthesiology·Edmond I Eger, James M Sonner
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Nov 9, 2016·Journal of the Formosan Medical Association = Taiwan Yi Zhi·Wei-Nung TengChien-Kun Ting
Oct 19, 2017·Anesthesiology·Robert M Knapp
Jun 27, 2003·Anesthesiology·Philippe Van der LindenJean-Louis Vincent
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Nov 30, 2011·The Journal of Veterinary Medical Science·Kazuto YamashitaKenjirou Miyoshi
Jun 17, 2020·The Kaohsiung Journal of Medical Sciences·Mahmut ArslanFeyza Çalışır

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