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Effect of Naloxone Reversal on CO 2 Output, Oxygen Uptake and Cardiac Index During Recovery from Fentanyl‐Supplemented Anaesthesia
Author(s) -
Tigerstedt Irma,
Tammisto Tapani
Publication year - 1978
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.1978.tb01293.x
Subject(s) - medicine , anesthesia , normocapnia , cardiac index , fentanyl , cardiac output , (+) naloxone , shivering , ventilation (architecture) , hypercapnia , respiratory minute volume , narcotic , stroke volume , opioid , heart rate , hemodynamics , respiratory system , blood pressure , acidosis , mechanical engineering , receptor , engineering
For reversal of contingent residual narcotic depression after fentanyl administration during balanced anaesthesia, the effect of 0.08 mg of naloxone on CO 2 output, O 2 uptake and cardiac index was studied immediately after extubation. This dose maintained normocapnia (5.7 kPa) during early recovery, while in the control group slight hypercapnia was present (6.0 kPa). No significant differences, however, could be detected between the groups in CO 2 output, O 2 uptake or cardiac index. When 0.16 mg of naloxone was given to six other patients 10 min after the anaesthesia, when spontaneous respiration had stabilized on the same level as in the control group, significant increases in respiratory minute volume and rate and CO 2 output were recorded as compared with the respective prenaloxone levels. O 2 uptake increased with simultaneous improvement of Pa O2 and the cardiac index also increased significantly. A slight but highly significant increase in CO 2 output was detected after 0.16 mg of naloxone in six patients during anaesthesia and volume‐controlled IPPV. A significant increase in Pa cO2 was also measured. These findings indicate that if naloxone is used postoperatively, a significant metabolic increase may take place due to increased muscular work, restlessness and shivering. Ventilation and cardiac output were adequate for demand under present conditions using 2 μg/kg of naloxone, but careful titration of naloxone is recommended in order to avoid harmful metabolic changes.