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January 1, 1994Anesthesia & Analgesia

Fentanyl or Alfentanil Decreases the Minimum Alveolar Anesthetic Concentration of Isoflurane in Surgical Patients

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Why the study?

Does fentanyl or alfentanil reduce the minimum alveolar anesthetic concentration of isoflurane in surgical patients?

Population

79 surgical patients in whom anesthesia was induced with thiopental

Comparison

Computer-assisted continuous infusions of… vs No opioid (0 ng/mL) with isoflurane

Design

Other

Authors

CWC WestmorelandResearch Triangle Park FoundationPSPeter S. SebelUniversity of IowaAGAdam Gropper

Discussion

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Implication

May guide adjunctive opioid dosing to reduce isoflurane needs; leaves open validation in randomized trials.

Structured PICO

Does fentanyl or alfentanil reduce the minimum alveolar anesthetic concentration of isoflurane in surgical patients?

P
Population
79 surgical patients in whom anesthesia was induced with thiopental
I
Intervention
Computer-assisted continuous infusions (CACI) of fentanyl (target plasma concentration 1, 3, 6, or 8 ng/mL) or alfentanil (target plasma concentration 70, 210, 400, or 1000 ng/mL) with a predetermined end-tidal concentration of isoflurane
C
Comparator
No opioid (0 ng/mL) with isoflurane
O
Outcome
Reduction of isoflurane minimum alveolar anesthetic concentration (MAC), determined by movement in response to skin incisionsurrogate

Fentanyl and alfentanil significantly reduce the MAC of isoflurane, with a comparative intraoperative potency ratio of 58:1.

Cite This Study

Westmoreland et al. (1994) studied this question.

synapsesocial.com/papers/6a7d152db920b2eb4977533chttps://doi.org/10.1213/00000539-199401000-00006
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Reduction of the MAC of Desflurane with Fentanyl1992 · 130 citations
  2. 2Esmolol Potentiates Reduction of Minimum Alveolar Isoflurane Concentration by Alfentanil1998 · 61 citations
  3. 3Potency (Minimum Alveolar Anesthetic Concentration) of Isoflurane Is Independent of Peripheral Anesthetic Effects1995 · 4 citations
  4. 4Comparison of Fentanyl, Sufentanil, and Alfentanil Anesthesia in Patients Undergoing Valvular Heart Surgery1984 · 66 citations
  5. 5Haemodynamic Effects of Fentanyl or Alfentanil as Adjuvants to Etomidate for Induction of Anaesthesia in Cardiac Patients1984 · 3 citations