Fentanyl statistics

In a prospective randomized comparison of combined sevoflurane plus remifentanil with combined fentanyl plus etomidate for induction of anesthesia in 10 patients with ischemic heart disease, 3 of the 20 patients given sevoflurane plus remifentanil developed severe bradycardia (heart rate less than 40) and one developed asystole, but the difference between the two groups did not reach statistical significance (20). Therefore, in patients with ischemic heart disease remifentanil should be used with caution, and concurrent administration of glycopyr-rolate 0.2 mg is advisable to reduce the incidence of bradycardia, hypotension, or both, without increasing the heart rate. 

Meuldermans WEG, Hurkmans RMA and Heykants JJP, Plasma protein binding and distribution of fentanyl, sulfentanil, alfentanil and lofentanil in blood. Arch. Int. Pharmacodyn., 257, 4-19 (1982). Cited in Lombardo E, Obach RS, Shalaeva MY and Gao E, Prediction of human volume of distribution values for neutral and basic drugs. 2. Extended data set and leave-class-out statistics, /. Med. Chem., 47, 1242-1250 (2004) ref. 276. 

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