Haemodynamic effects of rocuronium during fentanyl anaesthesia: comparison with vecuronium

Canadian Journal of Anesthesia/Journal canadien d'anesthésie, Aug 1993

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.

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Haemodynamic effects of rocuronium during fentanyl anaesthesia: comparison with vecuronium

Eamon P. McCoy FFARCSI 0 Venkat R. Maddineni mo FFARCSI 0 Peter Elliott MDFRCAnaes 0 Rajinder K. Mirakhur MDPhDFRCAnaes 0 Ian W. Carson MDFFARCSI 0 Ronald A. Cooper mt~ FFARCSI 0 0 From the Departments of Anaesthesia, The Queen's University and the Royal Victoria Hospital , Belfast,Northern Ireland . of Anaesthetics, The Queen's Universityof Belfast,Whitla Medical Building , 97 Lisburn Road, Belfast ,BT9 7BL, Northern Ireland (UK ). Acceptedfor publication 16th April , 1993 Haemodynamic variables were measured following administration o f rocuronium 0.6 mg "kg -I or vecuronium 0.08 mg" kg - I (approximately equivalent to 2 )< ED95 doses) in patients anaesthetized withfentany150 I~g" 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 o f 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 o f vecuronium was associated with decreases in heart rate (-7%), mean pulmonary artery pressure (-17%), central venous pressure ( - 1 5 % ) a n d 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 o f the variables between rocuronium and vecuronium. The absolute values o f all variables were, however, within acceptable clinical limits. There was no evidence o f histamine release in any patient. The present study shows that rocuronium 0.6 mg" kg -I is associated with changes o f only small magnitude in haemodynamic variables. - Haemodynamic effects of rocuronium during fentanyl anaesthesia: comparison with o vecuronlum Les variables h~modynamiques ont ~t~ mesur~es aprbs l'administration de rocuronium 0,6 rag" kg - t ou de v~curonium 0,8 mg" kg -~ (doses approximativement ~gales ~ 2 X ED95) chez des patients anesthksi~s avec du fentanyl 50 I~g" kg - t et programm~s pour subir une chirurgie de pontage aortocoronarien en routine. Il y a une augmentation du volume dgjection index~ (+15%)et d~ndex cardiaque (+11%)et une diminution de la pression capillaire pulmonaire bloqu~e (-25%) apr~s Fadministration de rocuronium (P < 0,05). Les modifications de fr~quence cardiaque (+7%), de pression art&idle moyenne (-5%), de r~sistance vasculaire syst~mique (-12~ et des autres parambtres mesur~s ou d~rivds sont insignifiantes. Par comparaison, l'administration de v~curonium est associ~e avec une diminution de la fr~quence cardiaque (-7%), de la pression d'artkre pulmonaire moyenne (-17%), de la pression veineuse centrale ( - 15%) et.du produit fr~quence cardiaque-pression art&ielle ( - 9 % ) (P < 0,05). Les modifications en pression art~rielle moyenne (-7%), en index cardiaque ( - 6 % ) et en r~sistance vasculaire syst~mique ( - 8 % ) apr~s le v~curonium sont insignificates. I1 n'y a aucune difference de variables entre le rocuronium et le v~curonium. Les valeurs absolues de toutes les variables se situent dans les limites cliniques acceptables. Des manifestations de lib&ation d'histamine ne se sont pr~sent~es chez aucun patient. Cette ~tude montre que le rocuronium 0,6 rag" kg - j n'est associ~ qu~ de faibles modifications des variables h~modynamiques. Cardiovascular stability is considered desirable in an ideal muscle relaxant. The introduction of vecuronium bromide and atracurium dibesylate considerably improved the flexibility in the clinical administration of muscle relaxants. The intermediate duration of action of these compounds is more suitable to the duration of action of the majority of routine surgery than that of any other clinically used nondepolarizing muscle relaxants. While in general both these agents provide cardiovascular stability, there have been reports of bradycardia with vecuronium and of histamine liberation with atmcurium. 1-5 In addition both have a relatively slow onset of action. 6 PipeTABLE I Patient characteristics (mean 5- SD) curonium and doxacurium which have been recently introduced, provide very good cardiovascular stability but are quite slow and long-acting. 6 Rocuronium is a new aminosteroidal competitive muscle relaxant which, in animal studies, has been shown to have a more rapid onset of action and minimal cardiovascular and vagal side effects in doses of up to 3-4 X ED95.7,8 Studies in humans have also confirmed the onset of action to be rapid with a duration of action resembling that of vecuronium.9,1~ The detailed haemodynamic effects of the drug have not yet been reported although routine observations during early neuromuscular studies have not shown important cardiovascular side effects. ]0-12The present study was undertaken to compare the haemodynamic effects of rocuroniu (...truncated)


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Eamon P. McCoy, Venkat R. Maddineni, Peter Elliott, Rajinder K. Mirakhur, Ian W. Carson, Ronald A. Cooper. Haemodynamic effects of rocuronium during fentanyl anaesthesia: comparison with vecuronium, Canadian Journal of Anesthesia/Journal canadien d'anesthésie, 1993, pp. 703-708, Volume 40, Issue 8, DOI: 10.1007/BF03009764