[Cisatracurium in coronary bypass operations--a comparison with pancuronium. Hemodynamic and neuromuscular effects in patients under chronic beta blocker treatment].
OBJECTIVE
The aim of the study was to compare haemodynamic and neuromuscular effects of cisatracurium and pancuronium in patients undergoing coronary artery bypass grafting (ASA III, good or moderately impaired LV function) who were chronically medicated with beta-adrenergic blocking agents.


METHODS
60 Patients were randomly assigned in a double-blind fashion to receive sufentanil/midazolam/etomidate and either pancuronium (2xED95, group P) or cisatracurium (2xED95, group C2 and 4xED95, group C4). Haemodynamic variables were measured using arterial and pulmonary arterial catheters, neuromuscular transmission was measured using electromyography.


RESULTS
The heart rate was significantly lower in group C2 (50.2 +/- 6.8 bpm) and in group C4 (54.3 +/- 11 bpm) than in the pancuronium group (62.4 +/- 13.2 bpm) 3 min after induction of anaesthesia and until 60 min after induction. None of the other haemodynamic parameters showed any difference between groups. Onset time was 5.22 +/- 3.43 min in group P, 6.42 +/- 2.1 min in group C2 and 2.92 +/- 1.2 min in group C4.


CONCLUSIONS
Under high-dose opioid induction, bradycardia must be considered if cisatracurium is administered to cardiac surgery patients.
Rauch
H
H
Universitätsklinikum Heidelberg, Klinik für Anästhesiologie, Im Neuenheimer Feld 110, 69120 Heidelberg. helmut_rauch@med.uni-heidelberg.de
Jung
I
I
Fleischer
F
F
Bauer
H
H
Martin
E
E
Motsch
J
J
D000293:Adolescent; D000319:Adrenergic beta-Antagonists / Q000009:adverse effects* / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000758:Anesthesia; D000818:Animals; D001279:Atracurium / Q000031:analogs & derivatives*; D001026:Coronary Artery Bypass; D004311:Double-Blind Method; D005260:Female; D006439:Hemodynamics / Q000187:drug effects*; D006632:Histamine / Q000097:blood; D006801:Humans; D007442:Intubation, Intratracheal; D008297:Male; D008875:Middle Aged; D003473:Neuromuscular Nondepolarizing Agents; D010197:Pancuronium; D009435:Synaptic Transmission / Q000187:drug effects
D000319:Adrenergic beta-Antagonists; D003473:Neuromuscular Nondepolarizing Agents; D001279:Atracurium; D006632:Histamine; D010197:Pancuronium; C101584:cisatracurium