Tamura T
Masui. 1989 Oct;38(10):1282-92.
Effects of fentanyl on left ventricular diastolic function were investigated in chronically instrumented dogs. An electromagnetic mitral flow probe was placed in the left atrium and a micromanometer was placed in the left atrium as well as in the left ventricle to measure ventricular pressure (LVP), left atrial pressure (LAP), derivative of left ventricular pressure (dp/dt), mitral flow (MIF) and ECG in conscious resting dogs. Following induction of anesthesia with thiopental (15-20 mg.kg-1) and vecuronium (0.1 mg.kg-1), fentanyl (10, 50 and 100 mcg.kg-1) was administered at 30 min intervals. The direct measurement of phasic MIF was used to obtain a set of diastolic indices: peak rapid filling period (PRFR), filling volume (FV), FV due to atrial contraction (FV-A), isovolumic relaxation period (IVRP) and diastolic filling period (DFP). Each diastolic index during conscious resting state was compared with that obtained during fentanyl anesthesia using paired t-test. There were no significant changes in those diastolic indices under fentanyl (10, 50 and 100 mcg.kg-1) anesthesia except PRFR and dp/dt under fentanyl 10 mcg.kg-1 which decreased. Although heart rate decreased about 50% under fentanyl, IVRP and PRFR did not increase significantly, but DFP (P less than 0.05) and FV (P less than 0.01) increased significantly. DFP correlated well with RR interval under conscious resting state under fentanyl anesthesia (r = 0.992 and r = 0.967). This study suggests that in the absence of surgical stress, fentanyl does not impair left ventricular diastolic function.
在长期植入仪器的犬类中研究了芬太尼对左心室舒张功能的影响。将电磁二尖瓣血流探头置于左心房,并将微压计置于左心房以及左心室内,以测量清醒静息犬的心室压力(LVP)、左心房压力(LAP)、左心室压力变化率(dp/dt)、二尖瓣血流(MIF)和心电图。在用硫喷妥钠(15 - 20mg·kg⁻¹)和维库溴铵(0.1mg·kg⁻¹)诱导麻醉后,每隔30分钟给予芬太尼(10、50和100μg·kg⁻¹)。采用直接测量相性MIF来获得一组舒张指标:快速充盈期峰值(PRFR)、充盈量(FV)、心房收缩导致的充盈量(FV - A)、等容舒张期(IVRP)和舒张充盈期(DFP)。使用配对t检验比较清醒静息状态下的每个舒张指标与芬太尼麻醉期间获得的指标。在芬太尼(10、50和100μg·kg⁻¹)麻醉下,除了10μg·kg⁻¹芬太尼下PRFR和dp/dt降低外,这些舒张指标没有显著变化。尽管在芬太尼作用下心率降低了约50%,但IVRP和PRFR没有显著增加,而DFP(P < 0.05)和FV(P < 0.01)显著增加。在清醒静息状态和芬太尼麻醉下,DFP与RR间期相关性良好(r = 0.992和r = 0.967)。本研究表明,在没有手术应激的情况下,芬太尼不会损害左心室舒张功能。