Elderly coronary artery bypass graft patients with left ventricular dysfunction are hemodynamically stable after two different doses of rocuronium.
OBJECTIVE
To clarify the detailed hemodynamic responses to bolus administration of 2x 95% effective dose (ED95) and 3x ED95 of rocuronium in elderly patients with left ventricular dysfunction undergoing elective coronary artery bypass grafting (CABG).


METHODS
Prospective, randomized, clinical study.


METHODS
University hospital.


METHODS
Twenty patients aged older than 65 who had coronary artery disease with left ventricular ejection fractions equal to or less than 40%.


METHODS
Using invasive cardiac monitoring, the detailed hemodynamic profile was obtained before and at 2, 4, 6, 8, and 10 minutes after the injection of rocuronium.


RESULTS
Minor changes in all the measured or derived hemodynamic variables within the two groups did not attain statistical significance. Except for a higher baseline and the subsequent mean arterial pressures in one group, there were neither statistically nor clinically significant differences between two different doses of rocuronium in any of the variables at any time.


CONCLUSIONS
The results demonstrate that bolus administration of rocuronium (2x to 3x ED95) in combination with high-dose fentanyl provides sufficient cardiovascular stability among elderly CABG patients with left ventricular dysfunction. The cardiovascular profile of the two different bolus doses was similar. Rocuronium, in both doses, appears to be a suitable agent for muscle relaxation, especially for patients who require a high degree of cardiovascular stability.
Uyar
M
M
Department of Anesthesiology, Ege University Hospital, Izmir, Turkey.
Askar
F Z
FZ
Demirag
K
K
D000368:Aged; D000732:Androstanols / Q000008:administration & dosage* / Q000494:pharmacology; D001026:Coronary Artery Bypass / Q000379:methods*; D017558:Elective Surgical Procedures; D005283:Fentanyl / Q000008:administration & dosage; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D003473:Neuromuscular Nondepolarizing Agents / Q000008:administration & dosage* / Q000494:pharmacology; D011446:Prospective Studies; D000077123:Rocuronium; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000150:complications*
D000732:Androstanols; D003473:Neuromuscular Nondepolarizing Agents; D005283:Fentanyl; D000077123:Rocuronium