Biomaterial Database

Effects of fentanyl on baroreceptor reflex control of heart rate in newborn infants. 1988

I Murat, and J C Levron, and A Berg, and C Saint-Maurice

Département d'Anesthésie-Réanimation Chirurgicale, Hôpital Saint-Vincent-de-Paul, Paris, France.

Baroreceptor reflex control of heart rate was studied in ten neonates and young infants before and after intravenous fentanyl (10 micrograms/kg). All infants were in stable condition while being mechanically ventilated. Mean (+/- SD) corrected gestational age was 40.1 +/- 3.7 weeks, mean weight 3120 +/- 700 g. The pressor response was tested using phenylephrine and the depressor response using nitroglycerin. Changes in heart rate (R-R interval) were plotted against changes in systolic arterial pressure, and the slope of the linear portion of this relationship expresses the baroreflex sensitivity. No significant changes in systolic arterial pressure, heart rate, and blood gas values were observed after fentanyl injection when compared to control values. Mean (+/- SEM) control phenylephrine slope was 8.44 +/- 2.05 msec/mmHg, and mean nitroglycerin slope was 2.54 +/- 0.37 msec/mmHg. Both slopes decreased significantly by 48% and 42%, respectively, after fentanyl injection (P less than 0.02). Mean plasma fentanyl concentrations measured at the end of each test were not statistically different (5.11 +/- 0.65 ng/ml and 4.28 +/- 0.58 ng/ml, respectively). This suggests that the baroreflex control of heart rate is present in term neonates and markedly depressed during fentanyl anesthesia. Changes in blood pressure occurring during fentanyl anesthesia have to be carefully considered, because cardiac output is principally rate-dependent in newborns.

UI	MeSH Term	Description	Entries
D007231	Infant, Newborn	An infant during the first 28 days after birth.	Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D011311	Pressoreceptors	Receptors in the vascular system, particularly the aorta and carotid sinus, which are sensitive to stretch of the vessel walls.	Baroreceptors,Receptors, Stretch, Arterial,Receptors, Stretch, Vascular,Stretch Receptors, Arterial,Stretch Receptors, Vascular,Arterial Stretch Receptor,Arterial Stretch Receptors,Baroreceptor,Pressoreceptor,Receptor, Arterial Stretch,Receptor, Vascular Stretch,Receptors, Arterial Stretch,Receptors, Vascular Stretch,Stretch Receptor, Arterial,Stretch Receptor, Vascular,Vascular Stretch Receptor,Vascular Stretch Receptors
D012018	Reflex	An involuntary movement or exercise of function in a part, excited in response to a stimulus applied to the periphery and transmitted to the brain or spinal cord.
D005283	Fentanyl	A potent narcotic analgesic, abuse of which leads to habituation or addiction. It is primarily a mu-opioid agonist. Fentanyl is also used as an adjunct to general anesthetics, and as an anesthetic for induction and maintenance. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1078)	Phentanyl,Duragesic,Durogesic,Fentanest,Fentanyl Citrate,Fentora,R-4263,Sublimaze,Transmucosal Oral Fentanyl Citrate,R 4263,R4263
D006339	Heart Rate	The number of times the HEART VENTRICLES contract per unit of time, usually per minute.	Cardiac Rate,Chronotropism, Cardiac,Heart Rate Control,Heartbeat,Pulse Rate,Cardiac Chronotropy,Cardiac Chronotropism,Cardiac Rates,Chronotropy, Cardiac,Control, Heart Rate,Heart Rates,Heartbeats,Pulse Rates,Rate Control, Heart,Rate, Cardiac,Rate, Heart,Rate, Pulse
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man