fentanyl has been researched along with Insulin Resistance in 3 studies
Fentanyl: A potent narcotic analgesic, abuse of which leads to habituation or addiction. It is primarily a mu-opioid agonist. Fentanyl is also used as an adjunct to general anesthetics, and as an anesthetic for induction and maintenance. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1078)
fentanyl : A monocarboxylic acid amide resulting from the formal condensation of the aryl amino group of N-phenyl-1-(2-phenylethyl)piperidin-4-amine with propanoic acid.
Insulin Resistance: Diminished effectiveness of INSULIN in lowering blood sugar levels: requiring the use of 200 units or more of insulin per day to prevent HYPERGLYCEMIA or KETOSIS.
| Excerpt | Relevance | Reference |
|---|---|---|
| "This study investigated whether remifentanil infusion decreased intraoperative hyperglycaemia and insulin resistance compared with intermittent fentanyl administration in patients undergoing elective cardiac surgery." | 5.34 | Remifentanil and perioperative glycaemic response in cardiac surgery: an open-label randomised trial. ( Badhwar, V; Boisen, M; Esper, S; Hayanga, H; Marquez, J; Monroe, A; Ruppert, K; Sciortino, C; Subramaniam, K, 2020) |
| Timeframe | Studies, this research(%) | All Research% |
|---|---|---|
| pre-1990 | 0 (0.00) | 18.7374 |
| 1990's | 0 (0.00) | 18.2507 |
| 2000's | 0 (0.00) | 29.6817 |
| 2010's | 2 (66.67) | 24.3611 |
| 2020's | 1 (33.33) | 2.80 |
| Authors | Studies |
|---|---|
| Subramaniam, K | 1 |
| Sciortino, C | 1 |
| Ruppert, K | 1 |
| Monroe, A | 1 |
| Esper, S | 1 |
| Boisen, M | 1 |
| Marquez, J | 1 |
| Hayanga, H | 1 |
| Badhwar, V | 1 |
| Windeløv, JA | 1 |
| Pedersen, J | 1 |
| Holst, JJ | 1 |
| Berent-Spillson, A | 1 |
| Love, T | 1 |
| Pop-Busui, R | 1 |
| Sowers, M | 1 |
| Persad, CC | 1 |
| Pennington, KP | 1 |
| Eyvazaddeh, AD | 1 |
| Padmanabhan, V | 1 |
| Zubieta, JK | 1 |
| Smith, YR | 1 |
| Trial | Phase | Enrollment | Study Type | Start Date | Status | ||
|---|---|---|---|---|---|---|---|
| The Effect of Intraoperative Continuous Remifentanil Infusion on Glycemic Response and Variability in Patients Undergoing Cardiac Surgery With Cardiopulmonary Bypass: A Prospective, Randomized, Open Label Clinical Trial[NCT02349152] | Phase 4 | 116 participants (Actual) | Interventional | 2016-01-31 | Completed | ||
| Influence of Insulin Resistance on Cognitive, Emotional and Opioid System Functioning in Women With Polycystic Ovary Syndrome[NCT00670800] | 14 participants (Actual) | Interventional | 2008-01-31 | Completed | |||
| [information is prepared from clinicaltrials.gov, extracted Sep-2024] | |||||||
"Percentage of patients with two or more intraoperative blood glucose levels greater than 180 mg/dl. Percentage in both groups will be estimated, then the difference in this statistic will form the primary outcome measure of this study.~(Primary Outcome changed on 06/15/2015-Change Approved by University of Pittsburgh IRB on 06/22/2015- First patient enrolled January 2016)" (NCT02349152)
Timeframe: Intraoperative period
| Intervention | Participants (Count of Participants) |
|---|---|
| Remifentanil Group | 17 |
| Fentanyl Group | 33 |
Time to extubation after completion of surgery in the operating room and intensive care unit (NCT02349152)
Timeframe: Immediate postoperative period until 30 days post-operatively
| Intervention | Hours (Median) |
|---|---|
| Remifentanil Group | 3 |
| Fentanyl Group | 2.5 |
Coefficient of variation in blood glucose levels. Denotes how large the fluctuations in blood glucose are. Higher numbers indicate increased variation. (NCT02349152)
Timeframe: From the start of induction till 24 hours postoperatively
| Intervention | Percent of Mean Glucose Level (Mean) |
|---|---|
| Remifentanil Group | 0.2 |
| Fentanyl Group | 0.2 |
Average dose of insulin (Units/ml) calculated for each group in the intraoperative period (NCT02349152)
Timeframe: Intraoperative period; Induction to end of surgery
| Intervention | Units/ml (Median) |
|---|---|
| Remifentanil Group | 2.9 |
| Fentanyl Group | 8.1 |
Blood glucose values that exceed 180 mg% will be counted (NCT02349152)
Timeframe: Intraoperative period, Induction to end of surgery
| Intervention | number of glucose values >180mg% (Median) |
|---|---|
| Remifentanil Group | 1.2 |
| Fentanyl Group | 2 |
Total units of regular insulin required post-operatively (NCT02349152)
Timeframe: From ICU Admission (After Surgery) Until 24 hours postoperatively
| Intervention | International Units (Median) |
|---|---|
| Remifentanil Group | 28.1 |
| Fentanyl Group | 23.5 |
Telephonic call Numeric pain scale; Scale is 0-10, with 10 being the highest pain. (NCT02349152)
Timeframe: 1, 3, 6 and 12 months after discharge from the hospital
| Intervention | score on a scale (Median) | |||
|---|---|---|---|---|
| S-LANSS 1 mo | S-LANSS 3 mo | S-LANSS 6 mo | S-LANSS 12 mo | |
| Fentanyl Group | 3 | 0 | 0 | 0 |
| Remifentanil Group | 1 | 0 | 0 | 0 |
Inflammatory mediator levels, Interleukin-1b (IL-1b), Interleukin 6 (IL-6) and Tumor Necrosis Factor Alpha (TNFa) (all measured in pg/ml) taken at: Prebypass, cardiopulmonary bypass (2 samples:30 min start of bypass (CPB-30) and end of bypass (CPB-END), postbypass, ICU 8 hours postoperative period (NCT02349152)
Timeframe: Perioperative period (Intraoperatively and 8 hours postoperatively)
| Intervention | pg/ml (Median) | ||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| IL-1b Pre-bypass | IL-1b CPB-30 | IL-1b CPB-END | IL-1b post-bypass | IL-1b 8-HR | IL-6 Pre-bypass | IL-6 CPB-30 | IL-6 CPB-END | IL-6 post-bypass | IL-6 8HR | TNFa-Pre-bypass | TNFa CPB-30 | TNFa CPB-END | TNFa post-bypass | TNFa 8HR | |
| Fentanyl Group | 1.2 | 1.1 | 1.2 | 1.3 | 1.2 | 2.6 | 10.3 | 78.3 | 90.9 | 92.3 | 10.4 | 12.6 | 14.8 | 17.2 | 11.2 |
| Remifentanil Group | 1.2 | 1.1 | 1.2 | 1.1 | 1.2 | 2.8 | 7.4 | 77.2 | 136 | 93.6 | 11.7 | 14.4 | 18.2 | 24.0 | 15.4 |
Blood glucose measured every hour (NCT02349152)
Timeframe: Intraoperative period; Induction to end of surgery
| Intervention | Mg/dL (Median) | ||
|---|---|---|---|
| Mean Introperative Blood Glucose | Peak Intraoperative Blood Glucose | Lowest Intraoperative Blood Glucose | |
| Fentanyl Group | 156 | 205 | 120 |
| Remifentanil Group | 141 | 178 | 117 |
Mean and peak blood glucose levels postoperatively (NCT02349152)
Timeframe: From ICU Admission (After Surgery) Until 24 hours postoperatively
| Intervention | mg/dl (Median) | |
|---|---|---|
| Mean Postoperative Blood Glucose | Peak Postoperative Blood Glucose | |
| Fentanyl Group | 139 | 175 |
| Remifentanil Group | 139 | 185 |
Pain scores; Every day 6 hour for 48 hours postoperative period (NCT02349152)
Timeframe: Every day 6 hour for 48 hours postoperative period
| Intervention | score on a scale (Mean) | |||||||
|---|---|---|---|---|---|---|---|---|
| Hours 0-6 | Hrs 7-12 | Hrs 13-18 | Hrs 19-24 | Hrs 25-30 | Hrs 31-36 | Hrs 37-42 | Hrs 43-48 | |
| Fentanyl Group | 7.18 | 6.09 | 5.18 | 5.73 | 5.65 | 5.94 | 5.18 | 5.10 |
| Remifentanil Group | 6.63 | 6.53 | 6.59 | 5.88 | 5.94 | 5.89 | 5.57 | 5.08 |
Postoperative outcomes collected from the Society of Thoracic Surgery (STS) database. 30 day Mortality (outcome 1) and 30 day Readmission (outcome 2) cerebral vascular accident(outcome 3), prolonged mechanical ventilation (outcome 4), renal failure (outcome 5), atrial fibrillation (outcome 6), cardiac arrest (outcome 7) (NCT02349152)
Timeframe: 30 day outcomes
| Intervention | participants (Number) | ||||||
|---|---|---|---|---|---|---|---|
| 30 day Mortality | 30 day Readmission | Cerebral Vascular Accident | Prolonged mechanical ventilation | renal failure | atrial fibrillation | cardiac arrest | |
| Fentanyl Group | 6 | 10 | 2 | 8 | 3 | 18 | 3 |
| Remifentanil Group | 1 | 3 | 0 | 8 | 3 | 24 | 3 |
Adreno-corticotrophic hormone (ACTH), Growth Hormone (GH) and Glucagon (measured as pg/ml) taken at: Prebypass, cardiopulmonary bypass (2 samples: 30 mins after start of bypass (CPB 30) and end of bypass (CPB END), post-bypass and ICU 8 hours postoperative period (NCT02349152)
Timeframe: Perioperative period (Intraoperatively and 8 hours postoperatively)
| Intervention | pg/ml (Median) | ||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ACTH pre-bypass | ACTH CPB-30 | ACTH CPB-END | ACTH post-bypass | ACTH 8-hr | GH-Pre-bypass | GH-CPB-30 | GH-CPB-END | GH-post-bypass | GH-8HR | Glucagon pre-bypass | Glucagon CPB-30 | Glucagon CPB-End | Glucagon post-bypass | Glucagon 8-HR | |
| Fentanyl Group | 7.4 | 57.8 | 30.7 | 49.1 | 41.3 | 872 | 3202 | 2545 | 4461 | 2696 | 192 | 338 | 481 | 408 | 459 |
| Remifentanil Group | 7.4 | 4.4 | 4.4 | 8.0 | 77.0 | 495 | 826 | 947 | 37364 | 3658 | 229 | 259 | 401 | 315 | 570 |
Serum cortisol levels (measured as µg/dl) taken at: Prebypass, cardiopulmonary bypass (2 samples: at start of bypass and end of bypass), postbypass, ICU 8 hours postoperative period (NCT02349152)
Timeframe: Perioperative period (Intraoperatively and 8 hours postoperatively)
| Intervention | µg/dl (Median) | ||||
|---|---|---|---|---|---|
| Serum Cortisol Prebypass | Serum Cortisol 30 Minute After Start of CPB | Serum Cortisol End of CPB | Serum Cortisol End of Surgery | Serum Cortisol Postoperative (8 Hours) | |
| Fentanyl Group | 12 | 24.5 | 29.0 | 28.0 | 45.0 |
| Remifentanil Group | 12 | 6.0 | 5.0 | 8.5 | 36.0 |
Von frey hair objective testing (NCT02349152)
Timeframe: 96 hours postoperatively
| Intervention | g/mm^2 (Mean) | ||
|---|---|---|---|
| Preop pain threshold | 48 Hr pain threshold | 96 hr pain threshold | |
| Fentanyl Group | 3.30 | 3.83 | 3.72 |
| Remifentanil Group | 3.24 | 3.71 | 3.60 |
"Mu-opioid binding potential in left amygdala measured before and after 4 months of Metformin treatment.~Mu-opioid binding potential is measured in vivo with C11-carfentanil positron emission tomography in women with PCOS before and after 4 months of metformin treatment.~Binding Potential is measured by the ratio of Mu-opioid receptor concentration (Bmax)/Receptor radiotracer (C11-carfentanil) affinity (Kd.)" (NCT00670800)
Timeframe: Baseline and after 4 months
| Intervention | ratio (Mean) |
|---|---|
| PCOS Affected Women Pre-Metformin (Baseline) | 2.28 |
| PCOS Affected Women Post-Metformin (After 4 Months) | 2.08 |
| Normal Controls | 2.03 |
"Mu-opioid binding potential in left nucleus accumbens is measured before and after 4 months of Metformin treatment.~Mu-opioid binding potential is measured in vivo with C11-carfentanil positron emission tomography in women with PCOS before and after 4 months of metformin treatment.~Binding Potential is measured by the ratio of Mu-opioid receptor concentration (Bmax)/Receptor radiotracer (C11-carfentanil) affinity (Kd.)~Control group was measured at baseline only." (NCT00670800)
Timeframe: Baseline and after 4 months
| Intervention | ratio (Mean) |
|---|---|
| PCOS Affected Women Pre-Metformin (Baseline) | 1.95 |
| PCOS Affected Women Post-Metformin (After 4 Months) | 1.65 |
| Normal Controls | 1.53 |
"Mu-opioid binding potential in right amygdala measured before and after 4 months of Metformin treatment.~Mu-opioid binding potential is measured in vivo with C11-carfentanil positron emission tomography in women with PCOS before and after 4 months of metformin treatment.~Binding Potential is measured by the ratio of Mu-opioid receptor concentration (Bmax)/Receptor radiotracer (C11-carfentanil) affinity (Kd.)~Control group was measured at baseline only." (NCT00670800)
Timeframe: Baseline and 4 months
| Intervention | ratio (Mean) |
|---|---|
| PCOS Affected Women Pre-Metformin (Baseline) | 2.28 |
| PCOS Affected Women Post-Metformin (After 4 Months) | 2.11 |
| Normal Controls | 2.06 |
"Mu-opioid binding potential in right nucleus accumbens measured before and after 4 months of Metformin treatment.~Mu-opioid binding potential is measured in vivo with C11-carfentanil positron emission tomography in women with PCOS before and after 4 months of metformin treatment.~Binding Potential is measured by the ratio of Mu-opioid receptor concentration (Bmax)/Receptor radiotracer (C11-carfentanil) affinity (Kd.)~Control group was measured at baseline only." (NCT00670800)
Timeframe: Baseline and after 4 months
| Intervention | ratio (Mean) |
|---|---|
| PCOS Affected Women Pre-Metformin (Baseline) | 2.40 |
| PCOS Affected Women Post-Metformin (After 4 Months) | 2.11 |
| Normal Control Women | 2.05 |
1 trial available for fentanyl and Insulin Resistance
| Article | Year |
|---|---|
Remifentanil and perioperative glycaemic response in cardiac surgery: an open-label randomised trial.
Topics: Adult; Aged; Aged, 80 and over; Analgesics, Opioid; Blood Glucose; Cardiac Surgical Procedures; Fema | 2020 |
2 other studies available for fentanyl and Insulin Resistance
| Article | Year |
|---|---|
Use of anesthesia dramatically alters the oral glucose tolerance and insulin secretion in C57Bl/6 mice.
Topics: Anesthetics; Animals; Blood Glucose; Butyrophenones; Drug Combinations; Female; Fentanyl; Glucose In | 2016 |
Insulin resistance influences central opioid activity in polycystic ovary syndrome.
Topics: Adult; beta-Endorphin; Binding Sites; Brain; Carbon Radioisotopes; Case-Control Studies; Female; Fen | 2011 |