Document Detail


Left ventricular regional wall motion and haemodynamic changes following bolus administration of pipecuronium or pancuronium to adult patients undergoing coronary artery bypass grafting.
MedLine Citation:
PMID:  7586108     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The objective of this study was to compare the haemodynamic and myocardial effects of pipecuronium and pancuronium in patients undergoing coronary artery bypass grafting (CABG) during benzodiazepine/sufentanil anaesthesia. Twenty-seven ASA III-IV patients received lorazepam (1-3 mg) po and midazolam ( < 0.1 mg.kg-1) i.v. before induction of anaesthesia with sufentanil (3-8 micrograms.kg-1) was administered to facilitate tracheal intubation. According to random allocation, each patient received either pipecuronium (150 micrograms.kg-1) or pancuronium (120 micrograms.kg-1) after sternotomy but before heparinization. Mean arterial pressure, central venous pressure (CVP), pulmonary artery pressure (PAP), ST segment position and ECG (leads III, V5, AVF) were monitored continuously throughout the procedure. Thermodilution determinations of CO in triplicate were made immediately before, and at two and five minutes after muscle relaxant administration. Multiplane transoesophageal echocardiography (TEE, midpapillary short axis views of the left ventricle) images were continuously recorded from ten minutes before until ten minutes after muscle relaxant administration and graded by two experienced echocardiographic readers. Heart rate, MAP and CO increased after administration of pancuronium (by 13.6 beats.min-1, 10.8 mmHg and 1.0 L.min-1 respectively) but not after pipecuronium (P < 0.05). Evidence of myocardial ischaemia was not detected in any patients using ECG ST segment analysis or TEE assessment of left ventricular wall motion. We conclude that pancuronium caused increases in HR, MAP and CO but that neither pancuronium nor pipecuronium caused myocardial ischaemia.
Authors:
G D Shorten; T Sieber; A D Maslow; J M Haering; L K Robertson; M E Comunale
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Canadian journal of anaesthesia = Journal canadien d'anesthésie     Volume:  42     ISSN:  0832-610X     ISO Abbreviation:  Can J Anaesth     Publication Date:  1995 Aug 
Date Detail:
Created Date:  1995-12-04     Completed Date:  1995-12-04     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8701709     Medline TA:  Can J Anaesth     Country:  CANADA    
Other Details:
Languages:  eng     Pagination:  695-700     Citation Subset:  IM    
Affiliation:
Department of Anesthesia and Critical Care, Beth Israel Hospital, Boston, MA 02215, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Anesthetics, Intravenous / administration & dosage
Blood Pressure / drug effects
Cardiac Output / drug effects
Central Venous Pressure / drug effects
Coronary Artery Bypass*
Echocardiography, Transesophageal
Electrocardiography / drug effects
Female
Heart Rate
Humans
Hypnotics and Sedatives / administration & dosage
Lorazepam / administration & dosage
Male
Midazolam / administration & dosage
Middle Aged
Myocardial Ischemia / etiology
Neuromuscular Nondepolarizing Agents / administration & dosage*
Pancuronium / administration & dosage*
Pipecuronium / administration & dosage*
Sufentanil / administration & dosage
Thoracotomy
Vecuronium Bromide / administration & dosage
Ventricular Function, Left / drug effects*
Chemical
Reg. No./Substance:
0/Anesthetics, Intravenous; 0/Hypnotics and Sedatives; 0/Neuromuscular Nondepolarizing Agents; 0/Pancuronium; 50700-72-6/Vecuronium Bromide; 56030-54-7/Sufentanil; 59467-70-8/Midazolam; 68399-58-6/Pipecuronium; 846-49-1/Lorazepam

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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