title: Effects of fentanyl, diazepam, and the combination of both on arterial baroreflex and sympathetic nerve activity in intact and baro-denervated dogs.
abstract: The combination of fentanyl and diazepam significantly decreases systemic vascular resistance and blood pressure. We attempted to elucidate the reason the combination of these drugs can reduce blood pressure. In alpha-chloralose-anesthetized dogs, we investigated the effects of fentanyl and diazepam on mean arterial pressure (MAP) and arterial baroreflex control of renal sympathetic nerve activity (RSNA) in both intact (Study 1) and baroreflex-denervated dogs (Study 2). Study 1 included five dogs that received fentanyl 10 micrograms/kg followed by diazepam 0.4 mg/kg after a 10-min interval. Five more received both drugs in reversed sequence. The arterial baroreflex depressor test was performed with sodium nitroprusside before and after administration of each drug. Sensitivity of arterial baroreflex was examined by using the ratio of maximum increase of RSNA to maximum decrease of MAP (delta RSNA/delta MAP). RSNA and MAP significantly decreased only after both drugs had been administered (P < 0.05). Fentanyl alone did not attenuate arterial baroreflex sensitivity. Diazepam after fentanyl and diazepam alone attenuated baroreflex sensitivity to the same extent (P < 0.05). Study 2 comprised 14 dogs that underwent further surgical preparation of bilateral carotid sinus, aortic, and vagal nerve denervations. Seven received fentanyl, 5 and 10 micrograms/kg, and the other seven received diazepam, a total of 0.4 mg/kg. Fentanyl decreased both RSNA and MAP. Diazepam decreased only MAP significantly. The results indicate that fentanyl decreases mainly sympathetic outflow, whereas diazepam attenuates arterial baroreflex. We conclude that these combined effects of fentanyl and diazepam significantly decrease arterial blood pressure.
authors.affiliation: Department of Anesthesiology, University of Kansas Medical Center, Kansas City 66160-7415.
authors.forename: C
authors.initials: C
authors.lastname: Taneyama
authors.forename: H
authors.initials: H
authors.lastname: Goto
authors.forename: N
authors.initials: N
authors.lastname: Kohno
authors.forename: K T
authors.initials: KT
authors.lastname: Benson
authors.forename: J
authors.initials: J
authors.lastname: Sasao
authors.forename: K
authors.initials: K
authors.lastname: Arakawa
mesh_terms: D000818:Animals; D001794:Blood Pressure / Q000187:drug effects*; D002698:Chloralose; D003975:Diazepam / Q000008:administration & dosage / Q000494:pharmacology*; D004285:Dogs; D004338:Drug Combinations; D004347:Drug Interactions; D005283:Fentanyl / Q000008:administration & dosage / Q000494:pharmacology*; D006339:Heart Rate / Q000187:drug effects; D007275:Injections, Intravenous; D009599:Nitroprusside / Q000494:pharmacology; D011311:Pressoreceptors / Q000187:drug effects*; D013562:Sympathectomy; D013564:Sympathetic Nervous System
chemical_list: D004338:Drug Combinations; D009599:Nitroprusside; D002698:Chloralose; D003975:Diazepam; D005283:Fentanyl