Vagotonic Effect of Remifentanil and Autonomic Nervous System Activity.
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Purpose
Remifentanil (RMFNT) is a very short active opioid, used for analgesia during general anaesthesia and for analgosedation in intensive care units (ICU). Registration for anesthesia includes bolus dose and continuous infusion, in ICU only infusion regimen is allowed. PK/PD 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 parasympaticomimetic 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 HF power and HF/(LF+HF) ratio in frequency domain and RMSSD, NN50, 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 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.
| Condition | Intervention |
|---|---|
|
Autonomic Nervous Sytem Activity Inluence of Remifentanil on Autonomic Nervous System |
Drug: Remifentanil |
| Study Type: | Interventional |
| Study Design: | Endpoint Classification: Safety Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Diagnostic |
| Official Title: | Vagotonic Effect of Remifentanil in Reference to Sympathetic or Parasympathetic Predominance of Autonomic Nervous System. |
- Vagomimetic effect of RMFNT in reference to autonomic nervous system activity [ Time Frame: up to 2 years ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 50 |
| Study Start Date: | May 2010 |
| Estimated Study Completion Date: | December 2014 |
| Estimated Primary Completion Date: | December 2014 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| No Intervention: Remifentanil, Vagotonic response |
Drug: Remifentanil
1mcg/kg iv dose, followed by 5 minutes ECG recording
Other Name: Ultiva
|
Eligibility| Ages Eligible for Study: | 18 Years to 65 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- patients ASA I-II status
- planned surgery under general anaesthesia
Exclusion Criteria:
- known sensivity to remifentanil
- anticipated problems with tracheal intubation
- incresed risk of aspiration
- diabetic patients
- patients taking medications with known influence on autonomic nervous system
Contacts and Locations| Poland | |
| Medical University of Gdansk | Recruiting |
| Gdansk, Poland, 80-211 | |
| Contact: Magdalena A. Wujtewicz, MD., PhD 48583493281 magwuj@gumed.edu.pl | |
More Information
No publications provided
| Responsible Party: | Radoslaw Owczuk, associate professor, Medical University of Gdansk |
| ClinicalTrials.gov Identifier: | NCT01714388 History of Changes |
| Other Study ID Numbers: | GUMed-Ow-004 |
| Study First Received: | October 23, 2012 |
| Last Updated: | October 24, 2012 |
| Health Authority: | Poland: Ethics Committee |
Keywords provided by Medical University of Gdansk:
|
remifentanil heart rate autonomic nervous system heart rate variability |
Additional relevant MeSH terms:
|
Remifentanil Analgesics, Opioid Analgesics Sensory System Agents Peripheral Nervous System Agents Physiological Effects of Drugs Pharmacologic Actions |
Central Nervous System Agents Therapeutic Uses Central Nervous System Depressants Hypnotics and Sedatives Anesthetics, Intravenous Anesthetics, General Anesthetics |
ClinicalTrials.gov processed this record on May 16, 2013