Comparison of cardiovascular effects of pipecuronium versus vecuronium in patients receiving sufentanil anesthesia for myocardial revascularization.
This study was designed to compare the cardiovascular effects of pipecuronium bromide (PIP) to vecuronium (V) when combined with sufentanil (SF) in patients undergoing coronary artery bypass surgery. Eighty-two patients were studied; 40 were normotensive and 42 had hypertension currently controlled by pharmacological therapy. All patients were randomly assigned to receive either intravenous V, 0.12 mg/kg, or PIP, 0.10 mg/kg. Anesthesia was induced with SF, 6 micrograms/kg, while breathing 100% oxygen. Hemodynamic data including heart rate, mean arterial pressure, pulmonary capillary wedge pressure, central venous pressure, cardiac index, systemic vascular resistance, pulmonary vascular resistance, and left ventricular stroke work index were collected at five points: prior to induction, 3 and 6 minutes after the complete administration of PIP or V, and 3 and 6 minutes after intubation. There were no statistical differences in hemodynamic changes associated with either PIP or V. In addition, there were no statistical differences in the hemodynamic parameters measured at the five time points between the normotensive and hypertensive patient groups. This study demonstrates that there are no significant hemodynamic changes between SF/PIP and SF/V when used during coronary artery surgery. Due to its associated stable hemodynamics, as well as its long duration of action, PIP could become a commonly used muscle relaxant for anesthesia for cardiac surgery.
Starr
N J
NJ
Department of Cardiothoracic Anesthesia, Cleveland Clinic Foundation, OH 44195.
Kraenzler
E J
EJ
Wong
D
D
Koehler
L S
LS
Estafanous
F G
FG
D015113:Androstane-3,17-diol / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000494:pharmacology; D000771:Anesthesia, Intravenous; D000777:Anesthetics / Q000008:administration & dosage*; D001794:Blood Pressure / Q000187:drug effects; D002302:Cardiac Output / Q000187:drug effects; D002496:Central Venous Pressure / Q000187:drug effects; D001026:Coronary Artery Bypass; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage / Q000031:analogs & derivatives*; D006339:Heart Rate / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009125:Muscle Relaxants, Central / Q000008:administration & dosage / Q000494:pharmacology*; D003473:Neuromuscular Nondepolarizing Agents / Q000008:administration & dosage / Q000494:pharmacology*; D017300:Pipecuronium; D010879:Piperazines / Q000008:administration & dosage / Q000494:pharmacology*; D011669:Pulmonary Wedge Pressure / Q000187:drug effects; D017409:Sufentanil; D014655:Vascular Resistance / Q000187:drug effects; D014673:Vecuronium Bromide / Q000008:administration & dosage / Q000494:pharmacology*
D000777:Anesthetics; D009125:Muscle Relaxants, Central; D003473:Neuromuscular Nondepolarizing Agents; D010879:Piperazines; D017300:Pipecuronium; D015113:Androstane-3,17-diol; D014673:Vecuronium Bromide; D017409:Sufentanil; D005283:Fentanyl