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Intravenous boluses of fentanyl, 1 μg kg-1, and remifentanil, 0.5 μg kg-1, give similar maximum ventilatory depression in awake volunteers.

Gelberg, Jan LU ; Jonmarker, Christer; Stenqvist, O and Werner, Olof LU (2012) In British Journal of Anaesthesia 108(6). p.1028-1034
Abstract
BACKGROUND: /st>The relative respiratory effects of fentanyl and remifentanil, administered as i.v. bolus, have not previously been studied. We determined what remifentanil bolus dose gave the same maximum depression of ventilation as 1 µg kg(-1) of fentanyl.



METHODS: /st>Twelve healthy volunteers rebreathed in a system designed to dampen variations in end-tidal carbon dioxide tension so that measurements would be obtained at similar levels of CO(2) stimulation. The minute ventilation was measured before (V(preinj)) and after injection (V(nadir)) of fentanyl, 1 µg kg(-1), and remifentanil, 0.25, 0.5, and 1 µg kg(-1). The remifentanil doses were plotted against V(nadir)/V(preinj) in a log-probit diagram to... (More)
BACKGROUND: /st>The relative respiratory effects of fentanyl and remifentanil, administered as i.v. bolus, have not previously been studied. We determined what remifentanil bolus dose gave the same maximum depression of ventilation as 1 µg kg(-1) of fentanyl.



METHODS: /st>Twelve healthy volunteers rebreathed in a system designed to dampen variations in end-tidal carbon dioxide tension so that measurements would be obtained at similar levels of CO(2) stimulation. The minute ventilation was measured before (V(preinj)) and after injection (V(nadir)) of fentanyl, 1 µg kg(-1), and remifentanil, 0.25, 0.5, and 1 µg kg(-1). The remifentanil doses were plotted against V(nadir)/V(preinj) in a log-probit diagram to determine what amount gave the same maximum ventilatory depression as the fentanyl dose.



RESULTS: /st>V(nadir) was [median (inter-quartile range)] 51 (38-64)% of V(preinj) after fentanyl, and 70 (61-77), 50 (46-56), and 29 (24-38)%, respectively, after remifentanil. The nadir occurred 5.0 (4.4-7.0) min after fentanyl, and 3.8 (2.7-4.6), 2.9 (2.7-3.2), and 3.0 (2.7-3.2) min after remifentanil injection. at ventilation nadir was 6.26 (5.98-6.62) kPa after fentanyl, and 6.18 (6.12-6.50), 6.11 (5.91-6.45), and 6.11 (5.93-6.45) kPa after remifentanil 0.25, 0.5, and 1 µg kg(-1), respectively. A remifentanil dose of 0.47 (0.42-0.62) µg kg(-1) was equidepressant to 1 µg kg(-1) of fentanyl. Fifteen minutes after fentanyl injection, the median minute ventilation was 30-40% less than after injection of remifentanil, 0.25 and 0.5 µg kg(-1) (P<0.05).



CONCLUSIONS: /st>Fentanyl, 1 µg kg(-1), and remifentanil, 0.5 µg kg(-1), gave similar maximum ventilatory depression. The onset of and recovery from ventilatory depression were faster with remifentanil. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
agents, v, fentanyl, analgesics opioid, remifentanil, analgesics, techniques, i
in
British Journal of Anaesthesia
volume
108
issue
6
pages
1028 - 1034
publisher
Macmillan
external identifiers
  • wos:000304199500021
  • pmid:22440314
  • scopus:84861359973
ISSN
1471-6771
DOI
10.1093/bja/aes029
language
English
LU publication?
yes
id
15b75c6a-9266-452f-be2e-e79adb60c840 (old id 2431534)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/22440314?dopt=Abstract
date added to LUP
2012-04-03 12:47:35
date last changed
2017-01-01 03:22:01
@article{15b75c6a-9266-452f-be2e-e79adb60c840,
  abstract     = {BACKGROUND: /st&gt;The relative respiratory effects of fentanyl and remifentanil, administered as i.v. bolus, have not previously been studied. We determined what remifentanil bolus dose gave the same maximum depression of ventilation as 1 µg kg(-1) of fentanyl. <br/><br>
<br/><br>
METHODS: /st&gt;Twelve healthy volunteers rebreathed in a system designed to dampen variations in end-tidal carbon dioxide tension so that measurements would be obtained at similar levels of CO(2) stimulation. The minute ventilation was measured before (V(preinj)) and after injection (V(nadir)) of fentanyl, 1 µg kg(-1), and remifentanil, 0.25, 0.5, and 1 µg kg(-1). The remifentanil doses were plotted against V(nadir)/V(preinj) in a log-probit diagram to determine what amount gave the same maximum ventilatory depression as the fentanyl dose. <br/><br>
<br/><br>
RESULTS: /st&gt;V(nadir) was [median (inter-quartile range)] 51 (38-64)% of V(preinj) after fentanyl, and 70 (61-77), 50 (46-56), and 29 (24-38)%, respectively, after remifentanil. The nadir occurred 5.0 (4.4-7.0) min after fentanyl, and 3.8 (2.7-4.6), 2.9 (2.7-3.2), and 3.0 (2.7-3.2) min after remifentanil injection. at ventilation nadir was 6.26 (5.98-6.62) kPa after fentanyl, and 6.18 (6.12-6.50), 6.11 (5.91-6.45), and 6.11 (5.93-6.45) kPa after remifentanil 0.25, 0.5, and 1 µg kg(-1), respectively. A remifentanil dose of 0.47 (0.42-0.62) µg kg(-1) was equidepressant to 1 µg kg(-1) of fentanyl. Fifteen minutes after fentanyl injection, the median minute ventilation was 30-40% less than after injection of remifentanil, 0.25 and 0.5 µg kg(-1) (P&lt;0.05). <br/><br>
<br/><br>
CONCLUSIONS: /st&gt;Fentanyl, 1 µg kg(-1), and remifentanil, 0.5 µg kg(-1), gave similar maximum ventilatory depression. The onset of and recovery from ventilatory depression were faster with remifentanil.},
  author       = {Gelberg, Jan and Jonmarker, Christer and Stenqvist, O and Werner, Olof},
  issn         = {1471-6771},
  keyword      = {agents,v,fentanyl,analgesics opioid,remifentanil,analgesics,techniques,i},
  language     = {eng},
  number       = {6},
  pages        = {1028--1034},
  publisher    = {Macmillan},
  series       = {British Journal of Anaesthesia},
  title        = {Intravenous boluses of fentanyl, 1 μg kg-1, and remifentanil, 0.5 μg kg-1, give similar maximum ventilatory depression in awake volunteers.},
  url          = {http://dx.doi.org/10.1093/bja/aes029},
  volume       = {108},
  year         = {2012},
}