Role of the autonomic nervous system in mediating the response to naloxone in canine hemorrhagic shock.

When the opiate antagonist naloxone is administered to anesthetized dogs subjected to hemorrhagic shock, there is a transient decrease in heart rate and sustained increases in mean arterial pressure, maximum left ventricular dp/dt, and cardiac output. Surgical cardiac denervation and pharmacologic blockade of autonomic receptors were employed to investigate the mechanisms of these two responses. The transient bradycardia was prevented by beta-adrenergic receptor blockade or cardiac denervation. The sustained response was unaffected by cardiac denervation, attenuated by either alpha- or beta-adrenergic receptor blockade, and potentiated by cholinergic receptor blockade. Naloxone had no significant effect on plasma catecholamines. The sustained hemodynamic response to naloxone appears to have two components: there is an increase in parasympathetic stimulation which modestly attenuates the adrenergic component of the response. The adrenergic stimulation of the heart after naloxone administration appears to result from potentiation of existing adrenergic stimulation and not from increased sympathoadrenal discharge. These sustained sympathetic and parasympathetic responses appear to result from the action of naloxone at a myocardial site.