[Circulatory effects of vecuronium as well as pancuronium under different conditions of anesthesia].
The cardiovascular effects of equipotent doses (1,25 X ED95) of vecuronium (70 micrograms/kg iv) and pancuronium (80 micrograms/kg iv) were studied in 16 patients scheduled for elective coronary artery bypass surgery during steady-state conditions of isoflurane (0,4-0,5 vol% end-tidal)-nitrous oxide anaesthesia. All patients were chronically treated with oral beta receptor-blocking agents. Vecuronium did not cause any significant cardiovascular changes whereas pancuronium produced increases in heart rate (13%), cardiac index (15%) and mean arterial pressure (4%) while systemic vascular resistance decreased (8%). In a second part of this study we analysed whether the magnitude of the vagolytic effects of pancuronium is influenced by the anaesthetic procedure and/or by preoperative beta-blocker therapy. A group of 8 patients who were pretreated with beta-receptor blockers and received fentanyl (7 micrograms/kg) during the anaesthetic procedure showed low control values of heart rate (HR), cardiac index (CI), mean arterial pressure (MAP) and the rate-pressure product (RPP) which were due to both, the antisympathetic effects of beta-blocker therapy and the central vagomimetic properties of fentanyl. The administration of pancuronium (80 micrograms/kg) caused the greatest percentage increases in HR (20%), CI (22%), MAP (8%) and RPP (31%) in this group of patients. In contrast, patients (n = 8) anaesthetized with isoflurane-nitrous oxide who were not on preoperative beta-receptor blocker medication, demonstrated higher haemodynamic control values and less increases in HR (10%), CI (10%) and RPP (15%), MAP did not change. The clinical significance of these findings is discussed.
Markschies-Hornung
A
A
Woroszylski
F
F
Schulte-Sasse
U
U
Tarnow
J
J
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000768:Anesthesia, General; D001026:Coronary Artery Bypass; D004347:Drug Interactions; D005283:Fentanyl; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D007530:Isoflurane; D009466:Neuromuscular Blocking Agents / Q000008:administration & dosage*; D009609:Nitrous Oxide; D010197:Pancuronium / Q000008:administration & dosage* / Q000031:analogs & derivatives*; D014673:Vecuronium Bromide
D000319:Adrenergic beta-Antagonists; D009466:Neuromuscular Blocking Agents; D014673:Vecuronium Bromide; D007530:Isoflurane; D010197:Pancuronium; D009609:Nitrous Oxide; D005283:Fentanyl
Untersuchungen der Kreislaufwirkungen von Vecuronium sowie von Pancuronium unter verschiedenen Anästhesie-Bedingungen.