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Ventilatory Response to Carbon Dioxide after Intra muscular and Epidural Fentanyl

Received from the Departments of Anesthesiology of Bicêtre Hospital, Paris-South University, Kremlin Bicêtre, France, and of The University of Pennsylvania, Philadelphia, Pennsylvania.

Abstract

The authors compared the effects of administration of fentanyl 200 µg on the Ventilatory response to carbon dioxide in two groups of nine healthy unpremedicated subjects: one group received fentanyl as an intramuscular injection; in the other group, fentanyl was injected into the epidural space. In the intra muscular group, the slope of the venti-latory response to CO₂ did not decrease significantly. In the epidural group, the slope of the Ventilatory response to CO₂ decreased significantly from 2.48 ± 1.05 to 1.77 ± 0.7, 1.74 ± 0.7, and 2.07 ± 0.74 L·min-¹·mm Hg^–1 at 30, 60, and 120 min after injection (x ± SD, P 0.05), respectively. At each time of the study, plasma fentanyl levels were significantly lower in the epidural group than in the intramuscular group (P 0.05). These results suggest that epidural fentanyl induces a non systemic Ventilatory depression that may be due to the rostral spread of the drug.

Key Words: ANALGESIA, NARCOTIC—fentanyl • ANESTHETIC TECHNIQUES—epidural, intramuscular • VENTILATION—carbon dioxide response

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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