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Myocardial protection induced by fentanyl in pigs exposed to high‐dose adrenaline
Author(s) -
Luz Vinicius Fernando,
Otsuki Denise Aya,
Gonzalez Maria Margarita Castro,
Negri Elnara Marcia,
Caldini Elia Garcia,
DamacenoRodrigues Nilsa Regina,
Malbouisson Luiz Marcelo Sá,
Viana Bruno Gonçalves,
Vane Matheus Fachini,
Carmona Maria Jose Carvalho
Publication year - 2015
Publication title -
clinical and experimental pharmacology and physiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 103
eISSN - 1440-1681
pISSN - 0305-1870
DOI - 10.1111/1440-1681.12456
Subject(s) - fentanyl , medicine , anesthesia , pharmacology , epinephrine
Summary The use of high doses of adrenaline is common in critical patients, especially during cardiac arrest. During these situations, myocardial dysfunction can be a result of multiple factors, including adrenaline use. In addition, opioids have been shown to have anti‐arrhythmic and anti‐ischemic mechanisms that may confer cardiac protection. This study aimed to evaluate the effects of fentanyl on myocardial function in pigs exposed to high‐dose adrenaline. After institutional ethics committee approval, 26 pigs were randomly allocated to receive either 20 μ g/kg fentanyl ( n = 10; fentanyl group) administered 5 min before five doses of adrenaline (20 μ g/kg), equivalent‐volume saline ( n = 10; saline group) using the same adrenaline dosing protocol, or neither fentanyl nor adrenaline ( n = 6; sham group). The fentanyl group showed lower levels of troponin at the end of the sixth hour compared with the saline group (1.91 ± 1.47 vs 5.44 ± 5.35 ng/mL, P = 0.019). Transmission electron microscopy and immunohistochemistry also showed less myocardial injury in the fentanyl group. The conclusion was reached that fentanyl attenuates myocardial injury caused by high‐dose adrenaline without blunting the hemodynamic effect of adrenaline.