Intraoperative catecholamine release in brain-dead organ donors is not suppressed by administration of fentanyl
Background and objective: Endogenous catecholamines are released in brain-dead organ donors following painful stimulation during retrieval surgery, and might be harmful to harvested organs. Our hypothesis was that inhibition of pain by fentanyl would inhibit such catecholamine release.
Methods: We tested 17 brain-dead organ donors in a randomized, placebo-controlled, double-blinded study. Blood samples for determination of epinephrine and norepinephrine concentrations were obtained before and 10 min after in take of either fentanyl 7 μg kg−1 or an equivalent volume of placebo. Further points of measurement were taken after skin incision and sternotomy. Mean arterial pressure and heart rate at these points were recorded.
Results: Catecholamine concentrations rose following painful stimuli. No differences in haemodynamics, between the fentanyl and the placebo group were detectable. Epinephrine concentrations, but not those of norepinephrine, were higher in the fentanyl group, reaching significance following sternotomy.
Conclusion: We conclude that the use of fentanyl (7 μg kg−1) was not effective in suppressing the catecholamine release, following painful surgical stimulation in brain-dead organ donors.(Accepted February 2003)
Key Words: ANALGESICS, OPIOID, fentanyl; BRAIN DISEASES, brain death; CATECHOLAMINES, epinephrine, norepinephrine; HEALTH SERVICES, ORGAN PROCUREMENT; SENSATION, pain.
c1 Correspondence to: Robert Fitzgerald, Ludwig Boltzmann Institute for Economy of Medicine in Anaesthesia and Intensive Care, Wolkersbergenstraße 1, Vienna, A-1130, Austria. E-mail: email@example.com; Tel: +43 1 80110 2701; Fax: +43 1 80110 2696