Acta anaesth. scand. 1978, 22, 234-240
Reversal of Fentanyl-Induced Narcotic Depression with Naloxone Following General Anaesthesia IRMATIGERSTEDT Department of Anaesthesia, Helsinki University Central Hospital, Helsinki, Finland
To study the need for and mode of naloxone reversal after liberal use of fentanyl during anaesthesia, a fixed-dose schedule of fentanyl (mean 6.5 jtg/kg/h) was applied intraoperatively to 60 patients, randomly divided into four treatment groups. After surgery and reversal of muscle relaxation, end-tidal C 0 2 was allowed to rise to 8% by manually assisted ventilation. Thereafter, 0.04 mg increments of naloxone were given i.v. every 3 min until spontaneous respiration maintained ETcoa below 8% (group I ) or below 6.5% (group 11). After similar intravenous reversal to that in groups I or 11, a n additional intramuscular dose of naloxone, identical to that given i.v., was given to groups I11 and IV after awakening from nitrous oxide. If ETco2 remained above 6.5%, mean spontaneous minute ventilation was lower than before anaesthesia and significantly (P6.5% after intravenous naloxone. After 15 min, the patients with additional intramuscular naloxone had significantly ( P i 0.05) lower values of Pco. than those with intravenous naloxone only. Postoperatively, a positive correlation (R = 0.35) between the total dose of naloxone and pain intensity could be demonstrated (P
Reversal of Fentanyl-Induced Narcotic Depression with Naloxone Following General Anaesthesia IRMATIGERSTEDT Department of Anaesthesia, Helsinki University Central Hospital, Helsinki, Finland
To study the need for and mode of naloxone reversal after liberal use of fentanyl during anaesthesia, a fixed-dose schedule of fentanyl (mean 6.5 jtg/kg/h) was applied intraoperatively to 60 patients, randomly divided into four treatment groups. After surgery and reversal of muscle relaxation, end-tidal C 0 2 was allowed to rise to 8% by manually assisted ventilation. Thereafter, 0.04 mg increments of naloxone were given i.v. every 3 min until spontaneous respiration maintained ETcoa below 8% (group I ) or below 6.5% (group 11). After similar intravenous reversal to that in groups I or 11, a n additional intramuscular dose of naloxone, identical to that given i.v., was given to groups I11 and IV after awakening from nitrous oxide. If ETco2 remained above 6.5%, mean spontaneous minute ventilation was lower than before anaesthesia and significantly (P6.5% after intravenous naloxone. After 15 min, the patients with additional intramuscular naloxone had significantly ( P i 0.05) lower values of Pco. than those with intravenous naloxone only. Postoperatively, a positive correlation (R = 0.35) between the total dose of naloxone and pain intensity could be demonstrated (P
