[Adrenergic cardiovascular responses during neuroleptanalgesia (author's transl)]

Abstract

During major abdominal surgery with neuroleptanalgesia unexplainable increases of arterial blood pressure were observed several times without being objectified until now. Therefore the actual plasma catecholamines in connection with haemodynamic parameters like arterial blood pressure, heart rate and peripheral pulse amplitude were compared with synchronously measured concentrations of fentanyl in 31 patients undergoing standardized neuroleptanalgesia. From the data obtained it could be shown that the parameters of circulation do not always correlate with the concentration of the analgesic. Activation of the sympathetic nervous system was found in spite of sufficient analgesic medication. It was observed, with a sometimes particularly critical increase of pressure and decrease of pulse amplitude, mainly during the surgical stimulation in the upper abdomen. The causes of these increases and the possibilities of prevention also by other drugs are discussed.