title: [Evaluation of the hemodynamic effects of pipecuronium bromide. Absence of adverse hemodynamic effects].
abstract: BACKGROUND
  Pipecuronium bromide is a new non depolarising muscle relaxant with a long duration of action; we considered its haemodynamic effects during general anaesthesia.
  
  
  METHODS
  Eight surgical patients (4 males, 4 females), mean age 44 years (range 29-65 years), ASA I-II, were studied. All patients were undergoing elective neurosurgical procedures (Hunt-Hess I-II). A radial artery-cannula was put in for blood pressure monitoring and a Swan-Ganz volumetric/ejection fraction fiber optic catheter was put in pulmonary artery via right internal jugular vein (EFV/OTDC-Baxter). A diazo-analgesic high dose fentanyl anaesthesia was given. All patients received pipecuronium bromide 0,1 mg/kg during stable haemodynamic conditions. Haemodynamic determinations were performed over following three times: T0 before the pipecuronium administration, T1 and T2, 3 and 15 minutes after administration respectively. These parameters were analysed: HR, MAP, MPAP, RAP, PCWP, CI RVEDVI, RVESVI, RVEF, SVRI, LVWI, RVWI, SvO2, DO2I, VO2I, O2ER, Qs/Qt (statistics: analysis of variance (two ways ANOVA) and orthogonal decomposition; for all statistical comparison, differences were considered significant when p < 0.05).
  
  
  RESULTS
  Only MAP and SVRI showed significant changes (p = 0.02 and p = 0.04), even if clinically modest. No other parameter showed any change at all.
  
  
  CONCLUSIONS
  Pipecuronium bromide did not show adverse haemodynamic effects; its haemodynamic repercussions are clinically negligible. The drug could be considered as first choice in long lasting operations for patients with potential cardiovascular instability.
authors.affiliation: Università degli Studi, Cattedra di Anestesia e Rianimazione Ospedale Civile, Brescia.
authors.forename: M
authors.initials: M
authors.lastname: Ardigò
authors.forename: M
authors.initials: M
authors.lastname: Venturini
authors.forename: G
authors.initials: G
authors.lastname: Amicucci
authors.forename: A
authors.initials: A
authors.lastname: Dicembrini
authors.forename: A
authors.initials: A
authors.lastname: Prandini
authors.forename: N
authors.initials: N
authors.lastname: Latronico
authors.forename: A
authors.initials: A
authors.lastname: Candiani
mesh_terms: D000328:Adult; D000368:Aged; D000769:Anesthesia, Inhalation; D000771:Anesthesia, Intravenous; D005260:Female; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D003473:Neuromuscular Nondepolarizing Agents / Q000009:adverse effects* / Q000494:pharmacology; D009493:Neurosurgery; D017300:Pipecuronium / Q000009:adverse effects* / Q000494:pharmacology
chemical_list: D003473:Neuromuscular Nondepolarizing Agents; D017300:Pipecuronium