Anesthetic interactions of midazolam and fentanyl: is there acute tolerance to the opioid?

Abstract:

:The anesthetic effects and interactions of midazolam and fentanyl were determined in terms of their reduction of enflurane MAC in dogs, and the effects of their specific antagonists were also investigated. Control enflurane MAC was determined by the tail clamp method in 18 mongrel dogs. Each animal then received an iv loading dose of midazolam followed by a constant infusion at 9.6 micrograms.kg-1.min-1 designed to produce a stable enflurane MAC reduction of approximately 40%, and enflurane MAC was determined following a 60-min observation period during which time the midazolam concentration in plasma stabilized. Fentanyl was then administered in a series of three incremental loading doses (15, 30, and 225 micrograms/kg) and infusions (0.05, 0.2, and 3.2 micrograms.kg-1.min-1) designed to produce enflurane MAC reductions of 30%, 50%, and 65%, respectively. Enflurane MAC was again determined following a 60-min observation period for each new infusion. In nine dogs after the fourth determination of enflurane MAC, fentanyl was discontinued and 1 mg/kg naloxone was administered iv every 10 min until enflurane MAC was determined for the last time. In the other nine dogs, midazolam was discontinued and 1.5 mg/kg flumazenil (RO 15-1788) was administered and enflurane MAC determined for the last time. The midazolam concentration in plasma remained stable at 414 +/- 134 ng/ml throughout the study, and in the absence of fentanyl reduced enflurane MAC by 40 +/- 10% (mean +/- SD). The addition of fentanyl produced significant further reductions in enflurane MAC.(ABSTRACT TRUNCATED AT 250 WORDS)

journal_name

Anesthesiology

journal_title

Anesthesiology

authors

Schwieger IM,Hall RI,Szlam F,Hug CC Jr

doi

10.1097/00000542-198904000-00021

subject

Has Abstract

pub_date

1989-04-01 00:00:00

pages

667-71

issue

4

eissn

0003-3022

issn

1528-1175

journal_volume

70

pub_type

杂志文章
  • Liability associated with obstetric anesthesia: a closed claims analysis.

    abstract:BACKGROUND:Obstetrics carries high medical liability risk. Maternal death and newborn death/brain damage were the most common complications in obstetric anesthesia malpractice claims before 1990. As the liability profile may have changed over the past two decades, the authors reviewed recent obstetric claims in the Ame...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0b013e318190e16a

    authors: Davies JM,Posner KL,Lee LA,Cheney FW,Domino KB

    更新日期:2009-01-01 00:00:00

  • On-demand rather than daily-routine chest radiography prescription may change neither the number nor the impact of chest computed tomography and ultrasound studies in a multidisciplinary intensive care unit.

    abstract:BACKGROUND:Elimination of daily-routine chest radiographs (CXRs) may influence chest computed tomography (CT) and ultrasound practice in critically ill patients. METHODS:This was a retrospective cohort study including all patients admitted to a university-affiliated intensive care unit during two consecutive periods o...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/01.anes.0000296069.00566.16

    authors: Kröner A,Binnekade JM,Graat ME,Vroom MB,Stoker J,Spronk PE,Schultz MJ

    更新日期:2008-01-01 00:00:00

  • Differences between aortic and radial artery pressure associated with cardiopulmonary bypass.

    abstract::Previous investigators have identified an aortic-to-radial artery pressure gradient thought to develop during rewarming and discontinuation of cardiopulmonary bypass. The authors measured mean aortic and radial artery pressures before, during, and after cardiopulmonary bypass in 30 patients, to determine when the pres...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199207000-00009

    authors: Rich GF,Lubanski RE Jr,McLoughlin TM

    更新日期:1992-07-01 00:00:00

  • Peripheral antinociceptive action of morphine and the synergistic interaction with lamotrigine.

    abstract:BACKGROUND:Lamotrigine inhibits glutamate release through the preferential blockade of voltage-dependent Na+ channels. In contrast, morphine reduces release of excitatory amino acids through the activation of opioid receptors and also inhibits tetrodotoxin-resistant Na+ channels on peripheral afferent neurons. The curr...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-200204000-00020

    authors: Argüelles CF,Torres-López JE,Granados-Soto V

    更新日期:2002-04-01 00:00:00

  • Flammability of endotracheal tubes during Nd-YAG laser application in the airway.

    abstract::The effects of the neodymium-yttrium aluminum garnet (Nd-YAG) laser on several commonly used endotracheal tubes were examined. Six different types of tubes were tested for flammability. Three tubes were clear, transparent polyvinylchloride with black lettering on the surface. One was yellow-green silicone rubber with ...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198611000-00010

    authors: Geffin B,Shapshay SM,Bellack GS,Hobin K,Setzer SE

    更新日期:1986-11-01 00:00:00

  • Midazolam potentiates nociceptive behavior, sensitizes cutaneous reflexes, and is devoid of sedative action in neonatal rats.

    abstract:BACKGROUND:The significant postnatal maturation of gamma-aminobutyric acid signaling in the developing brain is likely to have important implications for infant pain processing. Gamma-aminobutyric acid receptor activation evokes analgesia and sedation in the adult, but the impact of immature gamma-aminobutyric acid sig...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/01.anes.0000296079.45446.15

    authors: Koch SC,Fitzgerald M,Hathway GJ

    更新日期:2008-01-01 00:00:00

  • A Pharmacokinetic and Pharmacodynamic Study of Oral Dexmedetomidine.

    abstract:BACKGROUND:Dexmedetomidine is only approved for use in humans as an intravenous medication. An oral formulation may broaden the use and benefits of dexmedetomidine to numerous care settings. The authors hypothesized that oral dexmedetomidine (300 mcg to 700 mcg) would result in plasma concentrations consistent with sed...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0000000000003568

    authors: Chamadia S,Pedemonte JC,Hobbs LE,Deng H,Nguyen S,Cortinez LI,Akeju O

    更新日期:2020-12-01 00:00:00

  • Metabolism of ketamine stereoisomers by human liver microsomes.

    abstract::Ketamine is used clinically as a racemic mixture of optical isomers that differ in their analgesic properties and psychomimetic effects. Administered individually, or together as the racemate, ketamine enantiomers differ in their hepatic clearance and duration of anesthetic effect. S(+) ketamine exhibits a greater cle...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199212000-00022

    authors: Kharasch ED,Labroo R

    更新日期:1992-12-01 00:00:00

  • Antiemetic activity of propofol after sevoflurane and desflurane anesthesia for outpatient laparoscopic cholecystectomy.

    abstract:BACKGROUND:Controversy exists regarding the effectiveness of propofol to prevent postoperative nausea and vomiting. This prospective, randomized, single-blinded study was designed to evaluate the antiemetic effectiveness of 0.5 mg/kg propofol when administered intravenously after sevoflurane- compared with desflurane-b...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000542-199810000-00007

    authors: Song D,Whitten CW,White PF,Yu SY,Zarate E

    更新日期:1998-10-01 00:00:00

  • Relaxation before Debriefing during High-fidelity Simulation Improves Memory Retention of Residents at Three Months: A Prospective Randomized Controlled Study.

    abstract:BACKGROUND:High-fidelity simulation is known to improve participant learning and behavioral performance. Simulation scenarios generate stress that affects memory retention and may impact future performance. The authors hypothesized that more participants would recall three or more critical key messages at three months ...

    journal_title:Anesthesiology

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/ALN.0000000000002045

    authors: Lilot M,Evain JN,Bauer C,Cejka JC,Faure A,Balança B,Vassal O,Payet C,Bui Xuan B,Duclos A,Lehot JJ,Rimmelé T

    更新日期:2018-03-01 00:00:00

  • Cognitive Decline after Delirium in Patients Undergoing Cardiac Surgery.

    abstract:WHAT WE ALREADY KNOW ABOUT THIS TOPIC:Cardiac surgery is associated with cognitive decline and postoperative delirium. The relationship between postoperative delirium and cognitive decline after cardiac surgery is unclear WHAT THIS ARTICLE TELLS US THAT IS NEW:The development of postoperative delirium is associated wi...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0000000000002253

    authors: Brown CH 4th,Probert J,Healy R,Parish M,Nomura Y,Yamaguchi A,Tian J,Zehr K,Mandal K,Kamath V,Neufeld KJ,Hogue CW

    更新日期:2018-09-01 00:00:00

  • Effect of increased intracranial pressure on regional hypoxic pulmonary vasoconstriction.

    abstract::The effects of increased intracranial pressure (ICP) and increased cardiac output (QT) on the pulmonary vascular response to regional alveolar hypoxia were compared in pentobarbital-anesthetized, closed-chested dogs. A bronchial divider was inserted, the right lung (RL) was continuously ventilated with 100% O2, and th...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199003000-00017

    authors: Domino KB,Hlastala MP,Cheney FW

    更新日期:1990-03-01 00:00:00

  • Myocardial sensitization by thiopental to arrhythmogenic action of epinephrine in dogs.

    abstract::This study examined the interaction between thiopental and epinephrine in inducing ventricular arrhythmias in dogs. The arrhythmogenic threshold of epinephrine was determined during anesthesia with either halothane alone, thiopental alone, etomidate plus different doses of thiopental, or halothane plus different doses...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198912000-00017

    authors: Hayashi Y,Sumikawa K,Yamatodani A,Tashiro C,Wada H,Yoshiya I

    更新日期:1989-12-01 00:00:00

  • Relationship between cardiopulmonary bypass flow rate and cerebral embolization in dogs.

    abstract:BACKGROUND:Cerebral embolization is a primary cause of cardiac surgical neurologic morbidity. During cardiopulmonary bypass (CPB), there are well-defined periods of embolic risk. In theory, cerebral embolization might be reduced by an increase in pump flow during these periods. The purpose of this study was to determin...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199911000-00031

    authors: Sungurtekin H,Plöchl W,Cook DJ

    更新日期:1999-11-01 00:00:00

  • Bupivacaine-induced cardiac arrhythmias in sheep.

    abstract::Controversy persists about the cardiac toxicity of bupivacaine if accidentally administered intravenously during regional anesthesia. Using awake, unanesthetized sheep, we evaluated the cardiac effects of low and high equivalent doses of lidocaine and bupivacaine given intravenously over 10 s. All animals convulsed wi...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198401000-00004

    authors: Kotelko DM,Shnider SM,Dailey PA,Brizgys RV,Levinson G,Shapiro WA,Koike M,Rosen MA

    更新日期:1984-01-01 00:00:00

  • Ketamine Alters Hippocampal Cell Proliferation and Improves Learning in Mice after Traumatic Brain Injury.

    abstract:WHAT WE ALREADY KNOW ABOUT THIS TOPIC:WHAT THIS ARTICLE TELLS US THAT IS NEW: BACKGROUND:: Traumatic brain injury induces cellular proliferation in the hippocampus, which generates new neurons and glial cells during recovery. This process is regulated by N-methyl-D-aspartate-type glutamate receptors, which are inhibite...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0000000000002197

    authors: Peters AJ,Villasana LE,Schnell E

    更新日期:2018-08-01 00:00:00

  • Alpha 4 beta 2 neuronal nicotinic acetylcholine receptors in the central nervous system are inhibited by isoflurane and propofol, but alpha 7-type nicotinic acetylcholine receptors are unaffected.

    abstract:BACKGROUND:The mechanisms of action of general anesthetics are not completely understood. Many general anesthetics are reported to potentiate gamma-aminobutyric acid (GABAA) and glycine receptors in the central nervous system (CNS) and to inhibit the muscle-type nicotinic acetylcholine receptor (nAChR). The effects of ...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199704000-00016

    authors: Flood P,Ramirez-Latorre J,Role L

    更新日期:1997-04-01 00:00:00

  • Role of the O-linked β-N-acetylglucosamine in the cardioprotection induced by isoflurane.

    abstract:BACKGROUND:Cardiac protection by volatile anesthetic-induced preconditioning and ischemic preconditioning have similar signaling pathways. Recently, it was reported that augmentation of protein modified with O-linked β-N-acetylglucosamine (O-GlcNAc) contributes to cardiac protection. This study investigated the role of...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0b013e31822fcede

    authors: Hirose K,Tsutsumi YM,Tsutsumi R,Shono M,Katayama E,Kinoshita M,Tanaka K,Oshita S

    更新日期:2011-11-01 00:00:00

  • Ultra-long-duration local anesthesia produced by injection of lecithin-coated methoxyflurane microdroplets.

    abstract::This study was designed to evaluate a new drug delivery system. The authors undertook to determine if microdroplets prepared by encapsulating volatile anesthetics with a membrane of lecithin could be used for local anesthesia. Local anesthesia was determined by monitoring the response of the rat to tail clamping and e...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198511000-00004

    authors: Haynes DH,Kirkpatrick AF

    更新日期:1985-11-01 00:00:00

  • Preoperative electrocardiograms: patient factors predictive of abnormalities.

    abstract:BACKGROUND:Age is often the sole criterion for determining the need for preoperative electrocardiograms. However, screening electrocardiograms have not been shown to add value above clinical information. This study was designed to determine whether it is possible to target electrocardiograms ordering to patients most l...

    journal_title:Anesthesiology

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/ALN.0b013e31819fb139

    authors: Correll DJ,Hepner DL,Chang C,Tsen L,Hevelone ND,Bader AM

    更新日期:2009-06-01 00:00:00

  • Early exposure to anesthesia and learning disabilities in a population-based birth cohort.

    abstract:BACKGROUND:Anesthetic drugs administered to immature animals may cause neurohistopathologic changes and alterations in behavior. The authors studied association between anesthetic exposure before age 4 yr and the development of reading, written language, and math learning disabilities (LD). METHODS:This was a populati...

    journal_title:Anesthesiology

    pub_type: 杂志文章,多中心研究

    doi:10.1097/01.anes.0000344728.34332.5d

    authors: Wilder RT,Flick RP,Sprung J,Katusic SK,Barbaresi WJ,Mickelson C,Gleich SJ,Schroeder DR,Weaver AL,Warner DO

    更新日期:2009-04-01 00:00:00

  • Supervised Machine-learning Predictive Analytics for Prediction of Postinduction Hypotension.

    abstract:WHAT WE ALREADY KNOW ABOUT THIS TOPIC:WHAT THIS ARTICLE TELLS US THAT IS NEW: BACKGROUND:: Hypotension is a risk factor for adverse perioperative outcomes. Machine-learning methods allow large amounts of data for development of robust predictive analytics. The authors hypothesized that machine-learning methods can prov...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0000000000002374

    authors: Kendale S,Kulkarni P,Rosenberg AD,Wang J

    更新日期:2018-10-01 00:00:00

  • Halothane-induced lipid peroxidation and glucose-6-phosphatase inactivation in microsomes under hypoxic conditions.

    abstract::Halothane-induced lipid peroxidation was studied in microsomes from phenobarbital-pretreated male rats at defined steady state oxygen partial pressures (PO2). At PO2 less than 10 mmHg on addition of halothane to NADPH-reduced microsomes, significant increases in malondialdehyde (MDA) formation, oxygen uptake, and conj...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198501000-00009

    authors: de Groot H,Noll T

    更新日期:1985-01-01 00:00:00

  • Noninvasive Tracking of Anesthesia Neurotoxicity in the Developing Rodent Brain.

    abstract:BACKGROUND:Potential deleterious effect of multiple anesthesia exposures on the developing brain remains a clinical concern. We hypothesized that multiple neonatal anesthesia exposures are more detrimental to brain maturation than an equivalent single exposure, with more pronounced long-term behavioral consequences. We...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0000000000002229

    authors: Makaryus R,Lee H,Robinson J,Enikolopov G,Benveniste H

    更新日期:2018-07-01 00:00:00

  • Pulmonary vasoregulation by arginine vasopressin in conscious, halothane-anesthetized, and pentobarbital-anesthetized dogs with increased vasomotor tone.

    abstract:BACKGROUND:Arginine vasopressin (AVP) is an important "stress" hormone that is known to play a key role in cardiovascular homeostasis of the systemic circulation. In contrast, the effects of AVP on the pulmonary circulation have not been extensively investigated, and the extent to which general anesthesia alters the pu...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199409000-00017

    authors: Trempy GA,Nyhan DP,Murray PA

    更新日期:1994-09-01 00:00:00

  • Extubation Success Prediction in a Multicentric Cohort of Patients with Severe Brain Injury.

    abstract:BACKGROUND:Patients with brain injury are at high risk of extubation failure. METHODS:We conducted a prospective observational cohort study in four intensive care units of three university hospitals. The aim of the study was to create a score that could predict extubation success in patients with brain injury. RESULT...

    journal_title:Anesthesiology

    pub_type: 杂志文章,多中心研究

    doi:10.1097/ALN.0000000000001725

    authors: Asehnoune K,Seguin P,Lasocki S,Roquilly A,Delater A,Gros A,Denou F,Mahé PJ,Nesseler N,Demeure-Dit-Latte D,Launey Y,Lakhal K,Rozec B,Mallédant Y,Sébille V,Jaber S,Le Thuaut A,Feuillet F,Cinotti R,ATLANREA group.

    更新日期:2017-08-01 00:00:00

  • Cardiorespiratory effects of positive end-expiratory pressure during progressive tidal volume reduction (permissive hypercapnia) in patients with acute respiratory distress syndrome.

    abstract:BACKGROUND:In patients with acute respiratory distress syndrome (ARDS), the ventilatory approach is based on tidal volume (VT) of 10-15 ml/kg and positive end-expiratory pressure (PEEP). To avoid further pulmonary injury, decreasing VT and allowing PaCO2 to increase (permissive hypercapnia) has been suggested. Effects ...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199510000-00010

    authors: Ranieri VM,Mascia L,Fiore T,Bruno F,Brienza A,Giuliani R

    更新日期:1995-10-01 00:00:00

  • Cerebral extracellular glucose and lactate concentrations during and after moderate hypoxia in glucose- and saline-infused rats.

    abstract::To assess the effect of a glucose infusion on brain extracellular fluid (ECF) during systemic hypoxia, changes in glucose and lactate concentrations in cerebral ECF during and after moderate hypoxic hypoxia were measured in adult, conscious, unrestrained rats, with a microdialysis probe in the posterior hippocampus. T...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199210000-00017

    authors: Harada M,Okuda C,Sawa T,Murakami T

    更新日期:1992-10-01 00:00:00

  • Alfentanil pharmacokinetics and metabolism in humans.

    abstract::The metabolism of alfentanil was studied in three healthy subjects after a 1-h infusion of 2.5 mg alfentanil-3H. One of the subjects was a poor hydroxylator of debrisoquine. Pharmacokinetic parameters were similar in the three subjects and were in the same range as those reported for volunteers. The majority of the ad...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198810000-00012

    authors: Meuldermans W,Van Peer A,Hendrickx J,Woestenborghs R,Lauwers W,Heykants J,Vanden Bussche G,Van Craeyvelt H,Van der Aa P

    更新日期:1988-10-01 00:00:00

  • Myocardial hypercarbic acidosis reduces cardiac resuscitability.

    abstract:BACKGROUND:The severity of spontaneous myocardial hypercarbic acidosis during cardiac arrest previously has been predictive of the likelihood of restoring spontaneous circulation. The present study investigated whether hypercarbia itself impairs cardiac resuscitation. Since coronary perfusion pressure is the overriding...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199302000-00019

    authors: Maldonado FA,Weil MH,Tang W,Bisera J,Gazmuri RJ,Johnson B,D'Alessio A

    更新日期:1993-02-01 00:00:00