Hostname: page-component-78c5997874-mlc7c Total loading time: 0 Render date: 2024-11-14T05:19:38.907Z Has data issue: false hasContentIssue false
  • English
  • Français

Vasorelaxant effect of opioid analgesics on the isolated human radial artery

Published online by Cambridge University Press:  01 March 2006

S. Gursoy ,
I. Bagcivan ,
M. K. Yildirim ,
O. Berkan  and
T. Kaya
S. Gursoy
Affiliation:
Cumhuriyet University School of Medicine, Department of Anesthesiology, Sivas, Turkey
I. Bagcivan
Affiliation:
Cumhuriyet University School of Medicine, Department of Pharmocology, Sivas, Turkey
M. K. Yildirim
Affiliation:
Cumhuriyet University School of Medicine, Department of Pharmocology, Sivas, Turkey
O. Berkan
Affiliation:
Cumhuriyet University School of Medicine, Department of Cardio-thoracic Surgery, Sivas, Turkey
T. Kaya
Affiliation:
Cumhuriyet University School of Medicine, Department of Pharmocology, Sivas, Turkey
Get access

Extract

Summary

Background and objective: Arterial grafts are prone to vasospasm. Opioid analgesics are commonly used in the perioperative course of cardiac surgical procedures. Therefore, we investigated the direct effects of morphine, meperidine, fentanyl and remifentanil on the human radial artery. Methods: Radial artery segments, obtained from 20 patients, were precontracted with phenylephrine. Using the organ bath technique, the endothelium-independent vasodilatation was tested in vitro by addition of cumulative concentrations of morphine, meperidine, fentanyl and remifentanil in separate organ baths, in the presence or absence of naloxone. Indomethacin and NG-nitro-l-arginine methyl ester was added to all organ bath in order to determine the effects of prostaglandins and nitric oxide, respectively. Results: Morphine (10−8–10−4mol L−1), meperidine (10−10–10−6mol L−1), fentanyl (10−10–10−6mol L−1) and remifentanil (10−8–10−4mol L−1) caused a concentration-dependent vasorelaxation in the human being artery rings. The relaxations in the presence of naloxane did not change. The maximal relaxant effects of meperidine and fentanyl were significantly greater than those of morphine and remifentanil (P < 0.05). Conclusions: These findings indicate that morphine, meperidine, fentanyl and remifentanil produce concentration-dependent and endothelium-independent relaxations in human being radial artery rings. Meperidine and fentanyl are more potent relaxant agents than morphine and remifentanil in the human being radial artery in vitro.

Keywords

ANALGESICS OPIOID, morphine, meperidine, fentanyl, remifentanilSURGERY CARDIACCORONARY ARTERY BYPASS SURGERYRADIAL ARTERY
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 23 , Issue 6 , June 2006 , pp. 496 - 500
Copyright
© 2006 European Society of Anaesthesiology

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Manasse E, Sperti G, Suma H et al. Use of the radial artery for myocardial revascularization. Ann Thorac Surg 1996; 62: 1076–1083.Google Scholar
Carpentier A, Guermonprez JZ, Deloche A, Frechette C, Dubost C. The aorto-to-coronary radial artery bypass graft: a technique avoiding pathological changes in grafts. Ann Thorac Surg 1973; 16: 111–121.Google Scholar
Fisk RL, Bruoks CH, Callaghan JC, Dvorkin J. Experience with the radial artery graft for coronary bypass. Ann Thorac Surg 1976; 21: 513–518.Google Scholar
Acar C, Jebara VA, Portoghese M et al. Revival of the radial artery for coronary bypass grafting. Ann Thorac Surg 1992; 54: 652–660.Google Scholar
Chardigny C, Jebara VA, Acar C et al. Vasoreactivity of the radial artery. Comparison with the internal mammary artery and gastroepipoic arteries with implications for coronary artery surgery. Circulation 1993; 88: 115–127.Google Scholar
He G-W, Yang C-Q. Radial artery has higher receptor-mediated contractility but similar endothelium function compared to mammary artery. Ann Thorac Surg 1997; 63: 1346–1352.Google Scholar
He G-W, Yang C-Q. Use of verapamil and nitroglycerin solution in preparation of radial artery for coronary grafting. Ann Thorac Surg 1996; 61: 610–614.Google Scholar
Reyes AT, Frame R, Bromdan RF. Technique for harvesting the radial artery as a coronary artery bypass graft. Ann Thorac Surg 1995; 59: 118–126.Google Scholar
Dietle CA, Benoit CH. Radial artery graft for coronary revascularization: technical considerations. Ann Thorac Surg 1995; 60: 102–110.Google Scholar
Acar C, Jebara VA, Portoghese M et al. Comparative anatomy and histology of the radial artery and the internal thoracic artery-implication for coronary-artery bypass. Surg Radiol Anat 1991; 13: 283–288.Google Scholar
He GW, Yang CQ. Comparison among arterial grafts and coronary-artery – an attempt at functional classification. J Thorac Cardiovasc Surg 1995; 109: 707–715.Google Scholar
Rosenfeldt FL, He GW, Buxton BF, Angus JA. Pharmacology of coronary artery bypass grafts. Ann Thorac Surg 1999; 67: 878–888.Google Scholar
Toda N, Hatano Y. Alpha-adrenergic blocking action of fentanyl on the isolated aorta of the rabbit. Anesthesiology 1977; 46: 411–416.Google Scholar
Karasawa F, Iwanov V, Moulds RF. Sufentanil and alfentanil cause vasorelaxation by mechanisms independent of the endothelium. Clin Exp Pharmacol Physiol 1993; 20: 705–711.Google Scholar
Karasawa F, Iwanov V, Moulds RF. Effects of fentanyl on the rat aorta are mediated by alpha-adrenoceptors rather than by the endothelium. Br J Anaesth 1993; 71: 877–880.Google Scholar
He GW. Arterial grafts for coronary surgery: vasospasm and patency rate. J Thorac Cardiovasc Surg 2003; 121: 431–433.Google Scholar
Conant AR, Shackcloth MJ, Oo AY, Chester MR, Simpson AWM, Dihmis WC. Phenoxybenzamine treatment is insufficient to prevent spasm in the radial artery: the effect of other vasodilators. J Thorac Cardiovasc Surg 2003; 126: 448–454.Google Scholar
Bovill JG, Sebel PS, Stanley TH. Opioid analgesics in anesthesia: with special reference to their use in cardiovascular anesthesia. Anesthesiology 1984; 61: 731–755.Google Scholar
Searle NR, Roy M, Bergeron G et al. Hydromorphone patient-controlled analgesia (PCA) after coronary artery bypass surgery. Can J Anaesth 1994; 4: 198–205.Google Scholar
Lowenstein E, Hallowell P, Levine FH, Daggett WM, Austen WG, Laver MB. Cardiovascular responses to large doses of intravenous morphine in man. New Engl J Med 1969; 281: 1389–1393.Google Scholar
Gurbet A, Goren S, Sahin S, Uckunkaya N, Korfali G. Comparison of analgesic effects of morphine, fentanyl, and remifentanil with intravenous patient-controlled analgesia after cardiac surgery. J Cardiothorac Vasc Anesth 2004; 18: 755–758.Google Scholar
Blaise GA, Witzeling TM, Sill JC, Vinay P, Vanhoutte PM. Fentanyl is devoid of major effects on coronary vasoreactivity and myocardial metabolism in experimental animals. Anesthesiology 1990; 72: 535–541.Google Scholar
Yamanoue T, Brum JM, Estafanous FG, Ferrario CM, Khairallah PS. Effects of opioids on vasoresponsiveness of porcine coronary artery. Anesth Analg 1992; 74: 889–896.Google Scholar
Yamanoue T, Brum JM, Estafanous FG, Ferrario CM, Khairallah PS. Fentanyl attenuates porcine coronary arterial contraction through M3-muscarinic antagonism. Anesth Analg 1993; 76: 382–390.Google Scholar
White DA, Reitan JA, Kein ND, Thorup SJ. Decrease in vascular resistance in the isolated canine hindlimb after graded doses of alfentanil, fentanyl, and sufentanil. Anesth Analg 1990; 71: 29–34.Google Scholar
Shibata O, Todoroki S, Terao Y et al. Phosphatidylinositol responses are involved in the vascular effects of thiamylal and fentanyl. Can J Anaesth 1995; 42: 1164–1170.Google Scholar
Bugge-Asperheim B, Kiil F. Preload, contractility, and afterload as determinants of stroke volume during elevation of aortic blood pressure in dogs. Cardiovasc Res 1973; 7: 528–541.Google Scholar
Barner HB. Defining the role of the radial artery. Semin Thorac Cardiovasc Surg 1996; 8: 3–9.Google Scholar