The antifibrillatory effect of fentanyl, sufentanil and carfentanil in the acute phase of local myocardial ischaemia in the dog.
To determine the effect of strong analgesics on electrical instability (vulnerability to ventricular fibrillation), we examined the action of fentanyl (60 micrograms/kg), sufentanil (10 micrograms/kg) and carfentanil (3 micrograms/kg) on the ventricular fibrillation threshold (VFT) in a dog model of coronary artery occlusion. The effect of strong analgesics was compared with that of the first-generation beta-blocker propranolol (1.2 mg/kg) and the third-generation beta-blocker celiprolol (3 mg/kg). In the 5th minute of ischaemia, VFT declines in all groups of dogs. VFT values rise significantly from the 23rd to the 60th minute of ischaemia after opiate analgesic administration. The mean increase in VFT after opiate analgesics is less pronounced than after beta-blockers. Administration of opioid analgesics is followed by strong prevalence of vagal drive to the heart. Sympathetic drive to the heart after propranolol administration disappears and is depressed after the administration of celiprolol only. Blockers of the beta-receptors apparently intervene directly in the ischaemic focus and affect the "substrate" of electrical instability. The opioid analgesics probably exert their effect through a change in "substrate" modulation. There is an ongoing search for drugs that would stabilize the heart electrically in acute myocardial infarction, thus preventing sudden death. Our experimental results favour a combination of strong analgesics with other electrostabilizing drugs.
Hess
L
L
Institute of Clinical and Experimental Medicine, Prague, C.S.S.R.
Vrana
M
M
Vranova
Z
Z
Fejfar
Z
Z
D000319:Adrenergic beta-Antagonists / Q000494:pharmacology; D000701:Analgesics, Opioid / Q000494:pharmacology*; D000818:Animals; D017272:Celiprolol; D003327:Coronary Disease / Q000188:drug therapy*; D004285:Dogs; D005283:Fentanyl / Q000031:analogs & derivatives* / Q000494:pharmacology*; D006329:Heart Conduction System / Q000187:drug effects; D008297:Male; D011412:Propanolamines / Q000494:pharmacology; D011433:Propranolol / Q000494:pharmacology; D014693:Ventricular Fibrillation / Q000517:prevention & control*
D000319:Adrenergic beta-Antagonists; D000701:Analgesics, Opioid; D011412:Propanolamines; D011433:Propranolol; D017272:Celiprolol; C017114:carfentanil; D005283:Fentanyl