Document Detail


Rocuronium versus vecuronium during fentanyl induction in patients undergoing coronary artery surgery.
MedLine Citation:
PMID:  10527226     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the neuromuscular, ventilatory, and cardiovascular effects of rocuronium and vecuronium. DESIGN: Randomized, prospective, blinded study. SETTING: Tertiary care teaching center, single institution. PARTICIPANTS: Patients undergoing elective coronary artery bypass graft procedure. INTERVENTIONS: Patients received rocuronium, 1.0 mg/kg (n = 17), or vecuronium, 0.15 mg/kg (n = 15), during fentanyl induction of anesthesia. MEASUREMENTS AND MAIN RESULTS: Measures consisted of time to visual loss of orbicularis oculi twitches in response to facial nerve stimulation, ease of mask ventilation, hemodynamics, need for vasoactive drugs, and tracheal intubating conditions. Median time to twitch loss was faster (p < 0.05) after rocuronium (60 s) than after vecuronium (>84 s). Within 45 seconds, only 3 of 17 patients in the rocuronium group had moderate-to-severe difficulty with mask ventilation versus 12 of 15 patients in the vecuronium group (p < 0.05). Tracheal intubating conditions were excellent in all patients after rocuronium. In the vecuronium group, intubating conditions were excellent in 46%, good in 27%, and poor in 27% (p < 0.05 vrocuronium). Patients receiving vecuronium were more likely to require ephedrine and phenylephrine for hypotension (10/15 patients v 5/17 patients for rocuronium, p < 0.05). There were no clinically important differences in hemodynamic variables, oxygen metabolism, or myocardial ischemia between groups. CONCLUSION: During narcotic induction of anesthesia, rocuronium was associated with lower requirement for vasopressors, faster onset of neuromuscular blockade, and better conditions for mask ventilation and tracheal intubation compared with vecuronium.
Authors:
C E Smith; C Botero; C Holbrook; A C Pinchak; J F Hagen
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of cardiothoracic and vascular anesthesia     Volume:  13     ISSN:  1053-0770     ISO Abbreviation:  J. Cardiothorac. Vasc. Anesth.     Publication Date:  1999 Oct 
Date Detail:
Created Date:  1999-11-18     Completed Date:  1999-11-18     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9110208     Medline TA:  J Cardiothorac Vasc Anesth     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  567-73     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH 44109, USA.
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MeSH Terms
Descriptor/Qualifier:
Androstanols* / adverse effects,  pharmacology
Anesthesia
Anesthetics, Intravenous*
Coronary Artery Bypass*
Double-Blind Method
Female
Fentanyl*
Hemodynamics / drug effects
Humans
Hypotension / drug therapy,  etiology
Intubation, Intratracheal
Male
Middle Aged
Neuromuscular Blockade
Neuromuscular Nondepolarizing Agents* / adverse effects,  pharmacology
Oxygen / blood
Oxygen Consumption / drug effects
Prospective Studies
Respiration, Artificial
Vecuronium Bromide* / adverse effects,  pharmacology
Chemical
Reg. No./Substance:
0/Androstanols; 0/Anesthetics, Intravenous; 0/Neuromuscular Nondepolarizing Agents; 143558-00-3/rocuronium; 437-38-7/Fentanyl; 50700-72-6/Vecuronium Bromide; 7782-44-7/Oxygen

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


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