High‐Dose Analgesic Anesthesia with Morphine or Sufentanil in Propranolol‐Treated Dogs

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Abstract
In propranolol-pretreated dogs (2 mg/kg) the immediate cardiovascular effects of sufentanil (0.01 mg/kg) or morphine (4 mg/kg) were compared. Besides a 40% decrease in cardiac index (CI), sufentanil and morphine initiated quite different hemodynamic changes. Sufentanil did not significantly change mean arterial pressure (MAP), central venous pressure (CVP) and mean pulmonary artery pressure (MPAP), while the pulmonary capillary wedge pressure (PCWP) increased by 50%. After morphine, MAP declined by .apprx. 65%, and decreases in MPAP (14%) and PCWP (33%) were also observed. Propranolol reduced heart rate [HR] by 16%, and morphine caused no further reduction in HR. A decrease of .apprx. 30% was seen in HR after sufentanil. Sufentanil raised systemic vascular resistance index by 15%; morphine decreased it by 32%. Pulmonary vascular resistance index was unchanged after sufentanil, but increased after morphine. Right ventricular stroke work index was unaffected by both analgesics and morphine decreased left ventricular stroke work index by 80%. O2 transport index declined after both analgesics. Sufentanil reduced O2 consumption by 20%, while morphine left this parameter unaffected. Administration of high-dose sufentanil apparently leads to a stable circulation, even when a total .beta.-blockade exists.