Vagotonic Effect of Remifentanil and Autonomic Nervous System Activity.
Status:
Completed
Trial end date:
2015-03-01
Target enrollment:
Participant gender:
Summary
Remifentanil (RMFNT) is a very short active opioid, used for analgesia during general
anaesthesia and for analgesic and sedative effect in intensive care units (ICU) patients.
Registration for anesthesia includes bolus dose and continuous infusion, in ICU only infusion
regimen is allowed. Pharmacokinetic/pharmacodynamic parameters of RMFNT results in rapid
onset and offset of clinical effect, which makes this drug almost ideal in many situations.
Unfortunately, its vagomimetic influence on cardiac activity may result in decrease of heart
rate. It may be hypothesized that patients with parasympathetic predominance may be prone to
more intense parasympathomimetic effect of this opioid. An optimal method for assessment of
autonomic nervous system activity and assessment of influence of RMFNT on that activity is
Heart Rate Variability (HRV) analysis. Parasympathetic predominance is expressed as high
frequency (HF) power and HF/(LF+HF) (LF-low frequency) ratio in frequency domain and Root
Mean Square of the Successive Difference (RMSSD), the number of pairs of successive NNs that
differ by more than 50 ms (NN50), the proportion of NN50 divided by total number of NNs
(pNN50) in time domain. The aim of this study is to verify the hypothesis that patients with
predominance of parasympathetic activity are more subject to vagomimetic effect of RMFNT. HRV
based on 5 minutes electrocardiogram (ECG) recorded before and after bolus dose of RMFNT will
be analyzed. The occurrence of heart rate decrease will be than compared between patients
with sympathetic and parasympathetic predominance measured prior to drug injection.