Myocardial protection induced by fentanyl in pigs exposed to high-dose adrenaline

Author(s)

da Luz, Vinicius Fernando ; Otsuki, Denise Aya ; Castro Gonzalez, Maria Margarita ; Negri, Elnara Marcia ; Caldini, Elia Garcia ; Damaceno-Rodrigues, Nilsa Regina ; Sa Malbouisson, Luiz Marcelo ; Viana, Bruno Goncalves ; Vane, Matheus Fachini ; Carvalho Carmona, Maria Jose

• Document type: Journal article
• Source: Clinical and experimental pharmacology & physiology; v. 42, n. 10, p. 10-pg., 2015-10-01.

Abstract

The use of high doses of adrenaline is common in critical patients, especially during cardiac arrest. During these situations, myocardial dysfunction can be a result of multiple factors, including adrenaline use. In addition, opioids have been shown to have anti-arrhythmic and anti-ischemic mechanisms that may confer cardiac protection. This study aimed to evaluate the effects of fentanyl on myocardial function in pigs exposed to high-dose adrenaline. After institutional ethics committee approval, 26 pigs were randomly allocated to receive either 20 mu g/kg fentanyl (n = 10; fentanyl group) administered 5 min before five doses of adrenaline (20 mu g/kg), equivalent-volume saline (n = 10; saline group) using the same adrenaline dosing protocol, or neither fentanyl nor adrenaline (n = 6; sham group). The fentanyl group showed lower levels of troponin at the end of the sixth hour compared with the saline group (1.91 +/- 1.47 vs 5.44 +/- 5.35 ng/mL, P = 0.019). Transmission electron microscopy and immunohistochemistry also showed less myocardial injury in the fentanyl group. The conclusion was reached that fentanyl attenuates myocardial injury caused by high-dose adrenaline without blunting the hemodynamic effect of adrenaline. (AU)

• FAPESP's process: 11/09885-0 - Evaluation of the effects of fentanyl on myocardial function of swine receiving high-dose epinephrine
• Grantee: Maria José Carvalho Carmona
• Support Opportunities: Regular Research Grants