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Cardiovascular Effects of Nitrous Oxide During Meperidine Infusion in the Dog

THEODORE H. STANLEY, MD^*, ARUN V. BIDWAI, MD, JUDD K. LUNN, MD, and MICHAEL R. HODGES

*Associate Professor Anesthesiology/Surgery. Instructor in Anesthesiology. Fellow in Anesthesiology. Technical Research Supervisor. Department of Anesthesiology, University of Utah College of Medicine, 50 North Medical Drive, Salt Lake City, Utah 84132.

Abstract

The cardiovascular effects of a large dose of meperidine (8 mg/kg IV) followed by continued slower infusion of the drug (4 mg/kg/hr) and then addition of increasing concentrations (10 to 70 percent) of N₂O or nitrogen during continued meperidine infusion were determined in 18 dogs. Meperidine (8 mg/kg) produced a marked (p<0.01) decrease in stroke volume (SV), cardiac output (_T), systemic vascular resistance (SVR), mean arterial blood pressure

mean pulmonary artery pressure

and also reduced (p<0.05) mean right atrial pressure

but did not significantly change heart rate (HR). During continued meperidine infusion, SV, _T, and

increased until they became similar to premeperidine controls, while HR increased so that it was higher (p<0.05) than controls.

and SVR also increased during continued meperidine infusion; however, they remained less than control values. Addition of N₂O did not significantly change SV or

but produced reductions in HR and _T and increases in

and SVR when compared to similar concentrations of nitrogen.

These data demonstrate that rapid infusions of large doses of meperidine produce marked depression in cardiovascular dynamics which recover when the meperidine infusion is slowed. Addition of Na₂O during meperidine infusion results in significant reductions in HR and _T and increases in

and SVR. Our findings indicate that N₂O-meperidine anesthesia tends to preserve systemic blood pressure but at the expense of a reduced _T and increased SVR.

Key Words: ANESTHETICS, gases, nitrous oxide • ANALGESICS, narcotic, meperidine • HEART, myocardial function

Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999