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      The mechanisms of the direct vascular effects of fentanyl on isolated human saphenous veins in vitro.

      Journal of cardiothoracic and vascular anesthesia
      Analgesics, Opioid, antagonists & inhibitors, pharmacology, Calcium Channels, drug effects, physiology, Cyclooxygenase Inhibitors, Dose-Response Relationship, Drug, Drug Interactions, Fentanyl, Humans, Hypoglycemic Agents, In Vitro Techniques, Muscle Contraction, Muscle Relaxation, Muscle, Smooth, Vascular, Narcotic Antagonists, Nitric Oxide Synthase, Nitric Oxide Synthase Type III, Potassium Channel Blockers, Receptors, Opioid, Saphenous Vein, Serotonin, Sodium-Potassium-Exchanging ATPase, metabolism, Vasoconstriction, Vasodilation

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          Abstract

          The purpose of this study was to determine the mechanism of the direct effects of fentanyl on human veins in vitro. In vitro, prospective with repeated measures. University research laboratory. Dose-response curves were obtained for cumulative doses of fentanyl (10(-9)-10(-5) mol/L) on saphenous vein strips precontracted with (10(-6) mol/L) 5-hydroxytryptamine incubated with either naloxone (10(-4) mol/L), Nomega-nitroL-arginine-methyl ester (L-NAME) (10(-4) mol/L), indomethacin (10(-5) mol/L), glibenclamide (10(-4) mol/L), tetraethylammonium (10(-4) mol/L), or ouabain (10(-5) mol/L). Vein strips were also exposed to a Ca++-free solution and 0.1 mmol/L of ethylene glycol-bis-(b-aminoethylether) N,N'-tetraacetic acid; 5-hydroxytryptamine (10(-6) mol/L) was added to the bath before cumulative Ca++ (10(-4)-10(-2) mol/L). The same procedure was repeated in the presence of fentanyl (10(-6) , 3 x 10(-6) , or 10(-5) mol/L) (p < 0.05 = significant). Preincubation of vein strips with naloxone, L-NAME, or indomethacin did not influence the relaxant responses to fentanyl (p > 0.05). Tetraethylammonium, glibenclamide, and ouabain reduced the relaxation response to fentanyl (p < 0.05). A stepwise increase in tension was recorded with cumulative doses of Ca++ (p < 0.05). The present results show that fentanyl causes vasodilatation via both endothelium- and opioid receptor-independent mechanisms in the human saphenous vein. The relaxant effects of fentanyl are probably via activation of K+ channel and Na+K+-adenosine trisphosphatase and inhibition of Ca++ channel.

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