Comparison of the haemodynamic effects of mivacurium and atracurium during fentanyl anaesthesia.
We have measured the haemodynamic effects of mivacurium 0.15 and 0.2 mg kg-1, and atracurium 0.5 mg kg-1 administered over 10-15 s in patients undergoing coronary artery bypass surgery under fentanyl anaesthesia. There were no significant haemodynamic changes in the atracurium group, other than a transient decrease in pulmonary arterial wedge pressure. Changes in heart rate were small in all three groups. Mivacurium 0.15 mg kg-1 produced changes of only small magnitude (12% decrease in mean arterial pressure and 16% decrease in systemic vascular resistance index) however, mivacurium 0.2 mg kg-1 produced a 25% reduction in mean arterial pressure, a 14% increase in cardiac index and a 35% decrease in systemic vascular resistance index. Erythema developed in two, three and seven patients after atracurium, mivacurium 0.15 mg kg-1 and mivacurium 0.2 mg kg-1, respectively. One patient exhibited a 54% decrease in mean arterial pressure, generalized erythema and bronchospasm after mivacurium 0.2 mg kg-1. The haemodynamic changes with mivacurium suggested histamine release.
Loan
P B
PB
Department of Anaesthetics, Queen's University of Belfast.
Elliott
P
P
Mirakhur
R K
RK
Bunting
H F
HF
Bhanumurthy
S
S
McMurray
T J
TJ
D001279:Atracurium / Q000494:pharmacology*; D001794:Blood Pressure / Q000187:drug effects; D002302:Cardiac Output / Q000187:drug effects; D001026:Coronary Artery Bypass; D004334:Drug Administration Schedule; D004890:Erythema / Q000139:chemically induced; D005283:Fentanyl; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D007546:Isoquinolines / Q000494:pharmacology*; D000077590:Mivacurium; D009467:Neuromuscular Depolarizing Agents / Q000494:pharmacology*; D014655:Vascular Resistance / Q000187:drug effects
D007546:Isoquinolines; D009467:Neuromuscular Depolarizing Agents; D001279:Atracurium; D000077590:Mivacurium; D005283:Fentanyl