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Low-dose fentanyl does not alter muscle sympathetic nerve activity, blood pressure, or tolerance during progressive central hypovolemia
- Source :
- Am J Physiol Regul Integr Comp Physiol, Huang, M, Watso, J C, Belval, L N, Cimino, F A, Fischer, M, Jarrard, C P, Hendrix, J M, Hinojosa-Laborde, C & Crandall, C G 2022, ' Low-dose fentanyl does not alter muscle sympathetic nerve activity, blood pressure, or tolerance during progressive central hypovolemia ', American Journal of Physiology: Regulatory, Integrative and Comparative Physiology, vol. 322, no. 1, pp. R55-R63 . https://doi.org/10.1152/ajpregu.00217.2021
- Publication Year :
- 2021
- Publisher :
- American Physiological Society, 2021.
-
Abstract
- Hemorrhage is a leading cause of battlefield and civilian trauma deaths. Several pain medications, including fentanyl, are recommended for use in the prehospital (i.e., field setting) for a hemorrhaging solider. However, it is unknown whether fentanyl impairs arterial blood pressure (BP) regulation, which would compromise hemorrhagic tolerance. Thus, the purpose of this study was to test the hypothesis that an analgesic dose of fentanyl impairs hemorrhagic tolerance in conscious humans. Twenty-eight volunteers (13 females) participated in this double-blinded, randomized, placebo-controlled trial. We conducted a pre-syncopal limited progressive lower-body negative pressure test (LBNP; a validated model to simulate hemorrhage) following intravenous administration of fentanyl (75 µg) or placebo (saline). We quantified tolerance as a cumulative stress index (mmHg•min), which was compared between trials using a paired, two-tailed t test. We also compared muscle sympathetic nerve activity (MSNA; microneurography) and beat-to-beat BP (photoplethysmography) during the LBNP test using a mixed effects model (time [LBNP stage] x trial). LBNP tolerance was not different between trials (Fentanyl: 647 ± 386 vs. Placebo: 676 ± 295 mmHg•min, P = 0.61, Cohen's d = 0.08). Increases in MSNA burst frequency (time: P < 0.01, trial: P = 0.29, interaction: P = 0.94) and reductions in mean BP (time: P < 0.01, trial: P = 0.50, interaction: P = 0.16) during LBNP were not different between trials. These data, the first to be obtained in conscious humans, demonstrate that administration of an analgesic dose of fentanyl does not alter MSNA or BP during profound central hypovolemia, nor does it impair tolerance to this simulated hemorrhagic insult.
- Subjects :
- Adult
Male
Sympathetic Nervous System
Sympathoexcitatory
Physiology
medicine.medical_treatment
Analgesic
Hypovolemia
Blood Pressure
Hemorrhage
Placebo
Cardiovascular System
Fentanyl
Young Adult
Double-Blind Method
Physiology (medical)
Photoplethysmogram
Faculty of Science
medicine
Humans
Infusions, Intravenous
Muscle, Skeletal
Saline
Lower Body Negative Pressure
Cross-Over Studies
business.industry
Respiration
Cerebral tissue oxygenation
Microneurography
Middle Aged
Opioids
Analgesics, Opioid
Blood pressure
Anesthesia
Female
medicine.symptom
business
medicine.drug
Research Article
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Journal :
- Am J Physiol Regul Integr Comp Physiol, Huang, M, Watso, J C, Belval, L N, Cimino, F A, Fischer, M, Jarrard, C P, Hendrix, J M, Hinojosa-Laborde, C & Crandall, C G 2022, ' Low-dose fentanyl does not alter muscle sympathetic nerve activity, blood pressure, or tolerance during progressive central hypovolemia ', American Journal of Physiology: Regulatory, Integrative and Comparative Physiology, vol. 322, no. 1, pp. R55-R63 . https://doi.org/10.1152/ajpregu.00217.2021
- Accession number :
- edsair.doi.dedup.....5f12320e01e606db1d5806576babba21