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Canadian Journal of Anesthesia, Vol 33, 138-144, Copyright © 1986 by Canadian Anesthesiologists' Society

Haemodynamic Effects of Verapamil Administration after Large Doses of Fentanyl in Man

PATRICIA A. KAPUR MD1, EVELYN J. NOREL MBBS FFARCS1, HIMMET DAJEE MD1, GARY COHEN BS1, and WERNER FLACKE MD1

1 Anesthesiology and Surgery Services, Veterans Administration Medical Center, West Los Angeles, California, and the Departments of Anesthesiology and Surgery; UCLA School of Medicine, Los Angeles, California

Address correspondence to: Dr. Kapur, Department of Anesthesiology, UCLA School of Medicine, Center for the Health Sciences, Los Angeles, California 90024.

Thirteen patients with good left ventricular function undergoing coronary artery revascularization were studied to determine the cardiovascular effects of verapamil, 75-150 µg·kg-1., after a large dose (100 µg·kg-1.) of fentanyl, with pancuronium for muscle relaxation. The patients were continued on their usual cardiovascular medications until the time of surgery, which included nitrates, beta adrenergic blockers, and nifedipine. Anaesthesia with fentanyl was associated with decreases in mean arterial blood pressure, systemic vascular resistance, left ventricular stroke work index, and circulating catecholamine levels. Mean values were not further changed by verapamil, but individual patients had additional modest decreases in blood pressure and systemic vascular resistance. Cardiac index, however, was well maintained. Plasma catecholamines remained depressed after verapamil under the study condition. Thus, in patients with good left ventricular function, clinically relevant doses of verapamil were well tolerated even in the presence of an anaesthetic that included large doses of fentanyl, with suppression of circulating catecholamine levels

Key Words: ANALGESICS: fentanyl • ANAESTHETICS, intravenous • PHARMACOLOGY: verapamil • SYMPATHETIC NERVOUS SYSTEM: anaesthesia, catecholamine levels






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Copyright © 1986 by the Canadian Anesthesiologists' Society.