Abstract
Haemodynamic variables were measured following administration of rocuronium 0.6 mg· kg−1 or vecuronium 0.08 mg · kg−1 (approximately equivalent to 2 × ED95 doses) in patients anaesthetized with fentanyl 50 μg· kg−1 and scheduled to undergo elective coronary artery bypass grafting. There were increases in stroke volume index (+15%) and cardiac index (+11%), and a decrease in pulmonary capillary wedge pressure (−25%) following administration of rocuronium (P < 0.05). The changes in heart rate (+7%), mean arterial pressure (−5%), systemic vascular resistance (−12%) and other measured or derived indices were insignificant. In comparison the administration of vecuronium was associated with decreases in heart rate (−7%), mean pulmonary artery pressure (−17%), central venous pressure (−15%) and the rate-pressure product (−9%) (P < 0.05). The changes in mean arterial pressure (−7%), cardiac index (−6%) and systemic vascular resistance (−8%) following vecuronium were insignificant. There were no differences in any of the variables between rocuronium and vecuronium. The absolute values of all variables were, however, within acceptable clinical limits. There was no evidence of histamine release in any patient. The present study shows that rocuronium 0.6 mg · kg−1 is associated with changes of only small magnitude in haemodynamic variables.
Résumé
Les variables hémodynamiques ont été mesurées après l’administration de rocuronium 0,6 mg · kg−1 ou de vécuronium 0,8 mg · kg−1 (doses approximativement égales à 2 × ED95) chez des patients anesthésiés avec du fentanyl 50 μg · kg−1 et programmés pour subir une chirurgie de pontage aortocoronarien en routine. Il y a une augmentation du volume d’éjection indexé (+15%) et d’index cardiaque (+11%) et une diminution de la pression capillaire pulmonaire bloquée (−25%) après l’administration de rocuronium (P < 0,05). Les modifications de fréquence cardiaque (+7%), de pression artérielle moyenne (−5%), de résistance vasculaire systémique (−12%) et des autres paramètres mesurés ou dérivés sont insignifiantes. Par comparaison, l’administration de vécuronium est associée avec une diminution de la fréquence cardiaque (−7%), de la pression d’artère pulmonaire moyenne (−17%), de la pression veineuse centrale (−15%) et du produit fréquence cardiaque-pression artérielle (−9%) (P < 0,05). Les modifications en pression artérielle moyenne (−7%), en index cardiaque (−6%) et en résistance vasculaire systémique (−8%) après le vécuronium sont insignificates. Il n’y a aucune différence de variables entre le rocuronium et le vécuronium. Les valeurs absolues de toutes les variables se situent dans les limites cliniques acceptables. Des manifestations de libération d’histamine ne se sont présentées chez aucun patient. Cette étude montre que le rocuronium 0,6 mg· kg−1 n’est associé qu’à de faibles modifications des variables hémodynamiques.
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McCoy, E.P., Maddineni, V.R., Elliott, P. et al. Haemodynamic effects of rocuronium during fentanyl anaesthesia: comparison with vecuronium. Can J Anaesth 40, 703–708 (1993). https://doi.org/10.1007/BF03009764
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DOI: https://doi.org/10.1007/BF03009764