Transcranial Doppler ultrasonography with induction of anesthesia and neuromuscular blockade in surgical patients.
OBJECTIVE
To evaluate the cerebral vascular effects of cis-atracurium and rocuronium given after thiopental induction of anesthesia.


METHODS
Randomized, single-blinded study.


METHODS
University-affiliated hospital.


METHODS
39 adult ASA physical status I and II patients undergoing nonintracranial procedures.


METHODS
Patients received intravenously (IV), either saline placebo, cis-atracurium, or rocuronium after induction of general anesthesia with thiopental sodium.


METHODS
The right middle cerebral artery was insonated using a pulsed-wave range-gated transcranial Doppler, and data were recorded at preinduction, immediately postinduction, at injection of the study drug, and at 15-second intervals for 3 minutes thereafter. The variables recorded for each subject included the systolic, diastolic, and mean flow velocity, as well as pulsality index, systolic, diastolic, and mean arterial blood pressure (MAP), and end-tidal carbon dioxide concentration.


RESULTS
No significant differences between the groups were present in the postanesthetic induction maximal or minimal mean flow velocity.


CONCLUSIONS
cis-Atracurium and rocuronium, administered after thiopental, do not produce clinically relevant changes in cerebral blood flow velocity.
Kofke
W A
WA
Department of Anesthesiology, West Virginia University Health Sciences Center, Morgantown, USA. Kofkea@uphs.upenn.edu
Shaheen
N
N
McWhorter
J
J
Sinz
E H
EH
Hobbs
G
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D000732:Androstanols; D000758:Anesthesia; D018686:Anesthetics, Intravenous; D001279:Atracurium; D001794:Blood Pressure / Q000187:drug effects; D002245:Carbon Dioxide / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000502:physiology; D003473:Neuromuscular Nondepolarizing Agents; D000077123:Rocuronium; D013874:Thiopental; D017585:Ultrasonography, Doppler, Transcranial
D000732:Androstanols; D018686:Anesthetics, Intravenous; D003473:Neuromuscular Nondepolarizing Agents; D002245:Carbon Dioxide; D001279:Atracurium; D013874:Thiopental; D000077123:Rocuronium