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Anesth Analg 1988; 67:313-317
© 1988 International Anesthesia Research Society
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Analgesia and Ventilatory Response to Carbon Dioxide after Intramuscular and Epidural Alfentanil

Catherine Penon, MD, Isabelle Negre, MD, Claude Ecoffey, MD, Jeffrey B. Gross, MD, Jean-Claude Levron, PhD, and Kamran Samii, MD

Received from the Departments of Anesthesiology of Bicêtre Hospital, Université Paris-Sud, 94275 Kremlin-Bicêtre Cédex, France, and of Philadelphia Veterans Administration Medical Center, University of Pennsylvania, Philadelphia, Pennsylvania, and Laboratoires JANSSEN, 75116 Paris, France.

Abstract

The analgesic and ventilatory depressant effects of epidural and intramuscular alfentanil (15 µg/kg) were compared in two groups of seven healthy unpremedicated subjects. Fifteen minutes after IM injection, the slope of the ventilatory response to CO2 decreased significantly (from 2.72 ± 0.34 to 1.8 ± 0.20 L·min–1·mm Hg–1) while assessment of periosteal analgesia showed no change. After epidural injection, the slope of the ventilatory response to CO2 decreased significantly (from 2.32 ± 0.42 to 1.61 ± 0.29, 1.51 ± 0.29, and 1.53 ± 0.21 L ·min–1 ·mm Hg–1) at 15,45, and 90 minutes (x ± SD, P < 0.05), and there was significant periosteal analgesia of the tibia (15 and 30 minutes after injection) and of the radius (30 to 90 minutes after injection). Throughout the study, plasma alfentanil levels were similar after intramuscular and epidural injection. These results suggest that epidural alfentanil induces ventilatory depressiondue to the rostral spread of the drug rather than to systemic absorption.

Key Words: ANALGESICS—alfentanyl • ANESTHETIC TECHNIQUES, EPIDURAL—alfentanvl • PAIN—postoperative






Lippincott, Williams & Wilkins 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 HighWire Press
Copyright © 1988 by the International Anesthesia Research Society.