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Intraoperative catecholamine release in brain-dead organ donors is not suppressed by administration of fentanyl

Published online by Cambridge University Press:  11 July 2005

R. D. Fitzgerald ,
C. Hieber ,
E. Schweitzer ,
A. Luo ,
W. Oczenski  and
F. X. Lackner
R. D. Fitzgerald
Affiliation:
Ludwig Boltzmann Institute for Economics of Medicine in Anaesthesia and Intensive Care, Vienna, Austria
C. Hieber
Affiliation:
University of Vienna, Department of Anaesthesia and General Intensive Care, Vienna, Austria
E. Schweitzer
Affiliation:
Lainz Hospital, Department of Anaesthesia and Intensive Care, Vienna, Austria
A. Luo
Affiliation:
University of Vienna, Department of Anaesthesia and General Intensive Care, Vienna, Austria
W. Oczenski
Affiliation:
Lainz Hospital, Department of Anaesthesia and Intensive Care, Vienna, Austria
F. X. Lackner
Affiliation:
University of Vienna, Department of Anaesthesia and General Intensive Care, Vienna, Austria
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Extract

Summary

Background and objective: Endogenous catecholamines are released in brain-dead organ donors following painful stimulation during retrieval surgery, and might be harmful to harvested organs. Our hypothesis was that inhibition of pain by fentanyl would inhibit such catecholamine release.

Methods: We tested 17 brain-dead organ donors in a randomized, placebo-controlled, double-blinded study. Blood samples for determination of epinephrine and norepinephrine concentrations were obtained before and 10 min after in take of either fentanyl 7 μg kg−1 or an equivalent volume of placebo. Further points of measurement were taken after skin incision and sternotomy. Mean arterial pressure and heart rate at these points were recorded.

Results: Catecholamine concentrations rose following painful stimuli. No differences in haemodynamics, between the fentanyl and the placebo group were detectable. Epinephrine concentrations, but not those of norepinephrine, were higher in the fentanyl group, reaching significance following sternotomy.

Conclusion: We conclude that the use of fentanyl (7 μg kg−1) was not effective in suppressing the catecholamine release, following painful surgical stimulation in brain-dead organ donors.

Keywords

ANALGESICS, OPIOID, fentanylBRAIN DISEASES, brain deathCATECHOLAMINES, epinephrine, norepinephrineHEALTH SERVICES, ORGAN PROCUREMENTSENSATION, pain
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 20 , Issue 12 , December 2003 , pp. 952 - 956
Copyright
© 2003 European Society of Anaesthesiology

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