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Related Experiment Videos

Histamine release during morphine and fentanyl anesthesia.

C E Rosow, J Moss, D M Philbin

    Anesthesiology
    |February 1, 1982
    PubMed
    Summary

    Morphine causes significant hypotension and vasodilation due to histamine release, unlike fentanyl. This study demonstrates histamine

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    Area of Science:

    • Anesthesiology
    • Pharmacology
    • Cardiovascular Physiology

    Background:

    • High-dose morphine can cause peripheral vasodilation and hypotension, potentially linked to histamine release.
    • Fentanyl, another anesthetic, has a minimal impact on peripheral vascular resistance, suggesting different mechanisms of action.

    Purpose of the Study:

    • To investigate whether histamine release accounts for the hemodynamic differences observed between high-dose morphine and fentanyl.
    • To compare the effects of morphine and fentanyl on plasma histamine levels and cardiovascular parameters.

    Main Methods:

    • A randomized study involving 15 patients undergoing coronary artery bypass surgery.
    • Patients received either morphine (1 mg/kg) or fentanyl (50 mcg/kg) infusions.
    • Plasma histamine levels, mean arterial pressure, and systemic vascular resistance were measured.

    Main Results:

    • The morphine group exhibited a 750% increase in plasma histamine, accompanied by a significant decrease in mean arterial pressure (-27 mmHg) and systemic vascular resistance (-520 dyne·s·cm⁻⁵).
    • A strong negative correlation (r = -0.81) was found between plasma histamine levels and systemic vascular resistance in the morphine group.
    • The fentanyl group showed no significant changes in plasma histamine, arterial pressure, or systemic vascular resistance.

    Conclusions:

    • Histamine release is a primary factor explaining the differing effects of morphine and fentanyl on the peripheral vasculature.
    • Fentanyl offers a hemodynamic advantage over morphine in the context of anesthesia due to minimal histamine release.

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