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Diphenylhydramine increases ventilatory drive during alfentanil infusion
H D Babenco1, R T Blouin, P F Conard
1Department of Anesthesiology, University of Connecticut School of Medicine, Farmington 06030-2015, USA.
Anesthesiology
|September 22, 1998
Summary
Diphenhydramine counteracts opioid-induced respiratory depression by improving the ventilatory response to carbon dioxide. It does not worsen the effects of alfentanil on breathing during hypoxia or hypercapnia.
Area of Science:
- Anesthesiology
- Pharmacology
- Respiratory Physiology
Background:
- Diphenhydramine is commonly used for its antipruritic and antiemetic properties in patients receiving opioids.
- The potential impact of diphenhydramine on opioid-induced ventilatory depression remains unclear.
Purpose of the Study:
- To investigate whether diphenhydramine exacerbates opioid-induced ventilatory depression.
- To assess the effects of diphenhydramine on ventilatory responses to carbon dioxide and hypoxia during alfentanil administration.
Main Methods:
- Eight healthy volunteers underwent measurements of ventilatory response to carbon dioxide and hypoxia.
- These measurements were taken at baseline, during alfentanil infusion, and after diphenhydramine administration (0.7 mg/kg).
Main Results:
- Alfentanil decreased the slope of the ventilatory response to carbon dioxide and minute ventilation at specific PETCO2 levels.
- Diphenhydramine reversed the alfentanil-induced decrease in the slope of the carbon dioxide response curve.
- Diphenhydramine did not significantly alter alfentanil's effect on minute ventilation at PETCO2 = 46 mmHg but increased it at PETCO2 = 54 mmHg.
- Diphenhydramine did not exacerbate alfentanil-induced depression of the hypoxic ventilatory response.
Conclusions:
- Diphenhydramine counteracts the alfentanil-induced reduction in the ventilatory response to carbon dioxide.
- Diphenhydramine does not worsen opioid-induced respiratory depression during moderate hypercarbia or hypoxia.