Comparative Study of Fentanyl , Meperidine , and Morphine in Balanced Anesthesia / 대한마취과학회지

ABSTRACT

The hemodynamic changes during the induction and maintenance of anesthesia, the rapidity of postanesthetic recovery, and side effects were measured and compared in 60 patients receiving either morphine, meperidine, or fentanyl as supplements to balanced anesthesia. Blood pressure, measured through an indwelling arterial catheter, was recorded continuously, as were electrocardiogram and heart rates. The narcotics, made up in equipotent concentration, were given as indicated by hemodynamic and clinical signs. After induction, hemodynamic reponses to laryngoscopy and intubation were more suppressed in patients receiving fentanyl than in patients receiving morphine or meperidine. Meperidine, unilke morphine or fentanyl, significantly increased heart rates. Intraoperatively, mean arterial blood pressure and rate-pressure product were lowest in patients receiving fentanyl. Because of the increase in blood pressure, hart rate, or both to greater than 20% above preanesthetic values, supplementation with a potent inhalatinal agent was necessary, in 25%, 10%, and 10% of the patients given meperidine, morphine, and fentanyl, respectively. Side effects, including histamine release accompanied by tachycardia and hypotension, were most frequent and most severe in patients who received meperidine. Postoperatively, there was more rapid recovery of consciousness with fentanyl than meperidine and morphine and the incidence of postoperative respiratory depression was least with fentanyl. The authors concluded that a moderate dose of fentanyl was a better supplement to balanced anesthesia than morphine or meperidine.