Hemodynamic effects of diazepam-vecuronium-fentanyl sequence for induction of anesthesia for coronary artery surgery.
The hemodynamic effects of diazepam (0.2 mg/kg)--vecuronium (0.2 mg/kg)--fentanyl (10 micrograms/kg) sequence was investigated when used for induction of anesthesia and tracheal intubation in eleven patients undergoing CABG. The parameters monitored included HR, SBP, PAP and PCWP. Also, EKG was monitored via a modified V5 lead and C.O was measured by thermodilution. SVR, PVR and SV were computed from the measured parameters. Following induction of anesthesia by diazepam-vecuronium-fentanyl sequence, there was a decrease in SBP by 20.0% (P less than 0.05), in HR by 15.7% (P less than 0.001) in C.O by 13.3% (P less than 0.01) and in SVR by 13.6% (P less than 0.05) of control value. There were no changes in PAP, PCWP, PVR and SV. Coronary perfusion pressure and heart rate product were both decreased following this induction sequence. However, the percentage decrease in PR was higher than that of CPP, affecting favorably the myocardial oxygen supply-demand balance. Orotracheal intubation was followed by an increase of HR by 10.7% (P less than 0.05), SVR by 13% (P less than 0.05) and PCWP by 26% (P less than 0.05) of preceding value. However, all these values did not reach the control awake values. It was concluded that diazepam (0.2 mg/kg)--vecuronium (0.2 mg/kg)--fentanyl (10 micrograms/kg) sequence does not produce serious hemodynamic changes when used for induction of anesthesia and tracheal intubation in patients undergoing coronary artery bypass surgery.
D000758:Anesthesia; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000601:surgery; D003975:Diazepam / Q000494:pharmacology; D005283:Fentanyl / Q000494:pharmacology; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008875:Middle Aged; D010197:Pancuronium / Q000031:analogs & derivatives* / Q000494:pharmacology; D014673:Vecuronium Bromide
D014673:Vecuronium Bromide; D010197:Pancuronium; D003975:Diazepam; D005283:Fentanyl