Document Detail


A comparison of pipecuronium with pancuronium on haemodynamic variables and plasma catecholamines in coronary artery bypass patients.
MedLine Citation:
PMID:  8069985     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Pipecuronium bromide, a new neuromuscular relaxant with steroidal structure, is devoid of effects on the autonomic nervous system and may be useful in patients where haemodynamic stability is mandatory. However, tracheal intubation may alter this haemodynamic profile. Therefore, we carried out a prospective double-blind study in 30 patients undergoing coronary artery bypass surgery with the purpose (1) of determining if intubation influenced the haemodynamic stability in patients paralyzed with pipecuronium and (2) of comparing plasma catecholamine concentrations after pipecuronium with those after pancuronium. Thirty patients were randomized into two groups receiving either pipecuronium 100 micrograms.kg-1 or pancuronium 150 micrograms.kg-1 after induction of anaesthesia with midazolam and fentanyl. Haemodynamic variables and plasma catecholamines were measured before and after induction, after the muscle relaxant three times and twice after intubation. After anaesthesia induction decreases in heart rate (HR), mean arterial pressure (MAP) and cardiac index (CI) were observed in both groups. These haemodynamic variables were unchanged after pipecuronium whereas after pancuronium HR increased from 53 +/- 11 b.min-1 to 64 +/- 9 b.min-1 after induction (P < 0.05) and CI from 2.5 +/- 0.5 L.min-1 to 3.0 +/- 0.8 L.min-1 (P < 0.05). Furthermore ECG signs of myocardial ischaemia appeared in four patients after pancuronium and the decay of plasma norepinephrine concentration was slower than with pipecuronium. We conclude that pipecuronium given after induction of anaesthesia is free of sympathomimetic or vagolytic activity and does not influence haemodynamic variables for up to ten minutes after tracheal intubation.
Authors:
P P Neidhart; P Champion; J Vogel; E K Zsigmond; E Tassonyi
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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:  41     ISSN:  0832-610X     ISO Abbreviation:  Can J Anaesth     Publication Date:  1994 Jun 
Date Detail:
Created Date:  1994-09-29     Completed Date:  1994-09-29     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8701709     Medline TA:  Can J Anaesth     Country:  CANADA    
Other Details:
Languages:  eng     Pagination:  469-74     Citation Subset:  IM    
Affiliation:
Department of Anaesthesiology, University Hospital of Geneva, Switzerland.
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MeSH Terms
Descriptor/Qualifier:
Anesthesia, Intravenous
Blood Pressure / drug effects*
Cardiac Output / drug effects*
Catecholamines / blood*
Coronary Artery Bypass*
Double-Blind Method
Electrocardiography / drug effects
Epinephrine / blood
Female
Heart Rate / drug effects*
Humans
Intubation, Intratracheal
Male
Middle Aged
Myocardial Infarction / physiopathology
Norepinephrine / blood
Pancuronium / administration & dosage,  pharmacology*
Pipecuronium / administration & dosage,  pharmacology*
Prospective Studies
Chemical
Reg. No./Substance:
0/Catecholamines; 0/Pancuronium; 51-41-2/Norepinephrine; 51-43-4/Epinephrine; 68399-58-6/Pipecuronium
Comments/Corrections
Comment In:
Can J Anaesth. 1994 Jun;41(6):459-64   [PMID:  8069984 ]

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


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