[Meptazinol, a new analgesic. Hemodynamic and respiratory effects].
In a prospective, randomized double-blind study the hemodynamic and respiratory effects of i.v. meptazinol, a new synthetic narcotic agonist-antagonist analgesic given in 2 dosages (2 mg/kg and 4 mg/kg), were compared over 15 min to a control group that received 0.9% saline solution as placebo. In a total of 80 patients scheduled for elective aortocoronary bypass surgery, the study was performed before and during general anesthesia and during extracorporeal circulation (ECC). A dose-dependent increase in mean arterial pressure (MAP) and total systemic resistance (TSR) were the predominant hemodynamic effects of meptazinol before and during anaesthesia (Tables 1 and 2). Within the study period no change in heart rate (HR) or cardiac index (CI) could be observed. Directly measured left ventricular parameters revealed a significant increase in left ventricular pressure (LVEDP, and dp/dtmax (Fig. 1). During ECC meptazinol injection was followed by a dose-dependent increase in perfusion pressure, indicating a direct vasoconstrictive effect; no influence on the capacitance system ("venous pooling") could be observed (Fig. 2). In the spontaneously breathing, premedicated patients (morphine hydrochloride 0.15 mg/kg and flunitrazepam 0.03 mg/kg) paO2 increased and paCO2 decreased, especially after injection of the higher dosage of meptazinol; there was no influence on intrapulmonary right-to-left shunting (Qs/Qt).(ABSTRACT TRUNCATED AT 250 WORDS)
Boldt
J
J
Abteilung Anaesthesiologie und operative Intensivmedizin, Klinikum der Justus-Liebig-Universität Giessen.
Kling
D
D
von Bormann
B
B
Knoblauch
K
K
Görlach
G
G
Hempelmann
G
G
D001381:Azepines / Q000009:adverse effects*; D001794:Blood Pressure / Q000187:drug effects; D002986:Clinical Trials as Topic; D001026:Coronary Artery Bypass; D004311:Double-Blind Method; D005112:Extracorporeal Circulation; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D008297:Male; D008621:Meptazinol / Q000009:adverse effects* / Q000627:therapeutic use; D011229:Preanesthetic Medication; D011897:Random Allocation; D012119:Respiration / Q000187:drug effects*
D001381:Azepines; D008621:Meptazinol
Meptazinol, ein neuartiges Analgetikum. Hämodynamische und respiratorische Effekte.